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Eindhoven, Netherlands

Jansen L.,Catharina Ziekenhuis
Nederlands tijdschrift voor geneeskunde | Year: 2013

Ataxia due to a vitamin B12 deficiency can be a cause of falls in elderly patients. An 86-year-old woman presented with functional decline and gait problems. She had been falling regularly. The patient's gait was ataxic and she was unable to stand without support. Additional laboratory tests showed a volume macrocytic blood picture and a severe vitamin B12 deficiency, as well as antibodies directed against intrinsic factor and parietal cells. We diagnosed her as having falls and ataxia caused by vitamin B12 deficiency. Vitamin B12 supplementation resulted in improvement of gait. Ataxia due to vitamin B12 deficiency is a rare problem which in 20-25% of cases is not accompanied by anaemia. Prompt treatment reduces the chance of neurological sequelae. Source


Russo G.,TU Eindhoven | Russo G.,University of Amsterdam | Mischi M.,TU Eindhoven | Scheepens W.,Catharina Ziekenhuis | And 3 more authors.
BJU International | Year: 2012

As confirmed by all available statistics, cancer represents a major clinical and societal problem in the developed world. The form of cancer with the highest incidence in men is prostate cancer. For prostate cancer, as well as for most forms of cancer, detection of the disease at an early stage is critical to reduce mortality and morbidity. • Today, it is well known that pathological angiogenesis represents a crucial step in cancer development and progression. Comparable with most forms of cancer, angiogenesis also plays a fundamental role for prostate cancer growth. • As a consequence, angiogenesis is an ideal target not only for novel anti-angiogenic therapies, but also for modern imaging techniques that aim at cancer localisation by detection of angiogenic microvascular changes. • These techniques are mainly based on magnetic resonance, ultrasound, and nuclear imaging. • This paper provides a comprehensive review of the available studies on angiogenesis in prostate cancer and its use by modern and emerging imaging techniques for prostate cancer localisation. Accepted for publication 31 May 2012© 2012 THE AUTHORS. Source


Rademakers L.M.,Catharina Ziekenhuis | Laarman G.J.,TweeSteden Ziekenhuis
Netherlands Heart Journal | Year: 2012

We describe a case of critical hand ischaemia after transradial cardiac catheterisation. The patient presented with hand ischaemia 5 days after transradial coronary angiography. Urgent angiography demonstrated radial artery occlusion with embolisation to the palmar arch and digital arteries. The ischaemia was refractory to an extensive thrombolytic regimen, and subsequently, the patient was referred to the vascular surgeon for urgent thrombectomy and patch angioplasty. The patient recovered slowly and no amputation was necessary, but complaints of right hand numbness and paresthesia of all digits remained. © Springer Media / Bohn Stafleu van Loghum 2012. Source


Kortenhorst M.S.,Catharina Ziekenhuis
Nederlands tijdschrift voor geneeskunde | Year: 2012

Iron deficiency is a frequent cause of anaemia in pregnancy and often results in fatigue and malaise. To prevent complications during labour, timely iron suppletion is important. A 30-year-old multiparous female presented at the outpatient clinic in her 38th week of this pregnancy because of fatigue and lightheadedness. She had been prescribed oral iron suppletion a month earlier but had not taken the tablets. Because her haemoglobin level had decreased to 6.3 mmol/l, it was decided to start her on intravenous iron dextran treatment. During administration of the test dose, the patient experienced acute dyspnoea and severe abdominal and back pain. Foetal bradycardia was observed and the patient underwent an emergency caesarean section. She delivered a healthy boy whose arterial pH was 7.05 (base excess: -7.6 mmol/l) and venous pH was 7.18 (base excess: -6.8 mmol/l). This case demonstrates that dextran anaphylaxis can occur, with potentially lethal consequences, even when no known underlying risk factors are present. Source


A 64-year-old man was admitted to hospital with increasing low back pain, radiating to his upper legs. MRI of the lumbar spine showed inflammatory lesions of vertebrae L3-L5, after which the patient was treated with flucloxacilline for 6 weeks. However, he did not improve and the pain became more extensive. Finally, PET-CT study showed abnormalities in shoulders, back and hips, indicating a probable diagnosis of polymyalgia rheumatica. Upon treatment with prednisone, the pain quickly decreased and 3 months later the inflammatory changes visible on MRI were clearly reduced. Polymyalgia rheumatica (PMR) is often recognized by its typical clinical presentation, but in atypical cases, investigation using imaging may be helpful. Abnormalities in shoulder and hip joints are most common, but signs of cervical and lumbar interspinous bursitis might also be found in patients with PMR. Source

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