Published in Nederlands tijdschrift voor geneeskunde
Foreign body ingestion occurs frequently in children and may lead to severe complications and mortality. In this article, three cases are presented. A 2-year-old boy swallowed a plastic toy helmet. He had no symptoms and physical examination was normal, and the toy was found in the stool within three days. Similarly, a 6-year-old girl swallowed two...
Published in Nederlands tijdschrift voor geneeskunde
Care complexity is determined by patient-related factors and factors related to the care process, such as the number of caregivers involved with the patient. To be effective, care should be tailored to the context of the patient, and her or his possibilities and situation. Person-centred care focuses explicitly on this context and leads to better h...
Published in Nederlands tijdschrift voor geneeskunde
Physicians encounter patients who use antithrombotics in virtually every area of medical specialisation. As antithrombotic use is often chronic, it is important for medication monitoring that physicians have sufficient knowledge of the latest developments, even if they do not prescribe antithrombotics themselves. The risk of thrombosis must be weig...
Published in Nederlands tijdschrift voor geneeskunde
In general practice, we see complexity in the patient ('case complexity'), in the treatment ('care complexity'), and, to an important degree, in the context in which patient characteristics and environmental factors together lead to disease ('complexity thinking'). This context makes linear medical thinking, i.e. in which a symptom of a disease has...
Published in Nederlands tijdschrift voor geneeskunde
Morgellons disease is a controversial condition characterised by a great variety of skin-related symptoms such as wounds, itch and pain and whereby the patient strongly believes these are caused by threads or fibres penetrating the skin. The subject is often discussed in social media, which leads to increasing numbers of patients who think they hav...
Published in Nederlands tijdschrift voor geneeskunde
The pleural effusion found in urinothorax is traditionally classified as transudate. In some cases, however, the Light-criteria can show an exudate. We describe the case of a 30-year-old man who attended the emergency department with shortness of breath and severe, diffuse, chest pain; this occurred two days after he had undergone a left-sided perc...
Published in Nederlands tijdschrift voor geneeskunde
With an ageing population, the number of very old patients that are admitted to an intensive care unit (ICU) is also increasing. The possible benefit of ICU admission for these patients should be weighed against the risks of cognitive and functional impairment. Prospective studies are necessary to optimize the triage process and to identify factors...
Published in Nederlands tijdschrift voor geneeskunde
Necrobiosis lipoidica is a painless but disfiguring skin condition regularly complicated by ulceration and that is related to diabetes mellitus. We present the case of a 17-year-old girl with type 1 diabetes mellitus in whom necrobiosis lipoidica was diagnosed. After falling with a bicycle, a traumatic ulcer developed. The patient underwent several...
Published in Nederlands tijdschrift voor geneeskunde
Deep Brain Stimulation (DBS) is an effective intervention for Parkinson's disease if drug therapy with dopaminergic medication has become insufficient. Current post-operative care focuses on optimizing the neurostimulator in combination with medication. We believe that the success rate of DBS surgery can be enhanced if more attention is paid to the...
Published in Nederlands tijdschrift voor geneeskunde
Deep brain stimulation (DBS) is a treatment which uses high-frequency electric stimulation to suppress pathological brain activity. DBS has been applied for over 30 years now, particularly in patients with severe movement disorders, such as Parkinson's disease, dystonia and tremor. Although there is clearly scientific evidence for the effectiveness...
