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[Increased fracture risk and fracture prevention]. [增加骨折风险和预防骨折]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-07-15
Yvonne H M Krul-Poel, Patrick J W S Vrijlandt, Petra J M Elders, Joop P van den Bergh, Willem F Lems, Renate T de Jongh
{"title":"[Increased fracture risk and fracture prevention].","authors":"Yvonne H M Krul-Poel, Patrick J W S Vrijlandt, Petra J M Elders, Joop P van den Bergh, Willem F Lems, Renate T de Jongh","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>An increased fracture risk is a common chronic condition leading to a rising number of fractures, which are injurious to patients and costly to the health care system. Effective diagnostic and treatment options are available for fracture prevention. In this article, we will answer specific practical questions with respect to increased fracture risk and fracture prevention. Topics discussed include definitions, risk factors, the diagnostic modalities and treatment options.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[When is a medicine too expensive? Citizen consultation on the societal acceptability of expensive medicines]. 什么时候一种药会太贵？关于昂贵药品的社会可接受性的公民咨询]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-07-10
Rob M P M Baltussen, Leon A Bijlmakers, Maarten P M Jansen, C L M Brok, Marcia Tummers
{"title":"[When is a medicine too expensive? Citizen consultation on the societal acceptability of expensive medicines].","authors":"Rob M P M Baltussen, Leon A Bijlmakers, Maarten P M Jansen, C L M Brok, Marcia Tummers","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To gain insight into the considerations that citizens find important for the societal acceptability of prices and expenditures on expensive medicines.</p><p><strong>Design: </strong>Citizens' forum and representative survey.</p><p><strong>Method: </strong>A forum of 24 citizens formulated key reimbursement considerations following case discussions. Subsequently, an online survey (n=884) assessed how broadly these considerations were supported.</p><p><strong>Results: </strong>Citizens are more willing to accept higher prices for severe conditions, complete recovery from illness, or when medicines contribute to improved quality of life, or societal participation. At the same time, they draw clear boundaries: uncertainty about effectiveness, limited innovation, or excessively high prices undermine acceptability. Policymakers should explicitly consider these preferences in managing reimbursement decisions. Citizens believe the government must have the courage to say 'no' to excessively expensive medicines and urge manufacturers to be transparent and socially accountable regarding their pricing practices.</p><p><strong>Conclusion: </strong>Citizens consider a wide range of factors, accepting higher prices only when benefits are evident. Their preferences align with existing criteria used by public agencies, yet highlight the need for refinement, particularly regarding transparency, pricing, and market behaviour. Structural citizen participation can further strengthen public support for difficult choices in health care.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Financial toxicity in cancer patients]. [癌症患者的经济毒性]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-07-10
Jente M Klok, David Van Klaveren, Joachim G J V Aerts
{"title":"[Financial toxicity in cancer patients].","authors":"Jente M Klok, David Van Klaveren, Joachim G J V Aerts","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cancer patients experience income loss and extra expenses which can contribute to ongoing difficulties regarding their financial situation. This objective financial burden has significant implications for the psychological and physical well-being of survivors, yet there is a lack of guidance and support to navigate financial challenges. By recognizing financial toxicity and taking proactive measures, healthcare professionals should better assist cancer survivors in navigating financial challenges they may encounter at the long-term.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[A man with multiple skin eruptions]. [皮肤多处出疹的男子]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-07-09
Louise Devolder, An Nollet, Barbara Deconinck
{"title":"[A man with multiple skin eruptions].","authors":"Louise Devolder, An Nollet, Barbara Deconinck","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We present the case of a 59-year-old male with multiple papules covering his arms and legs. A biopsy was suggestive for eruptive xanthomas. Additional biochemistry showed a triglyceride count of 900 mg/dL and a hemoglobin A1c of 11,4%. The diagnosis of diabetes mellitus was made, without other symptoms of weight loss, polydipsia or polyuria.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Anxiety for MRI- or CT-examination: the impact of psychological treatment]. [MRI或ct检查的焦虑：心理治疗的影响]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-07-08
Nina H C Peeters, Petra C G Simons, H G G van Balen
{"title":"[Anxiety for MRI- or CT-examination: the impact of psychological treatment].","authors":"Nina H C Peeters, Petra C G Simons, H G G van Balen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Anxiety frequently leads to prematurely discontinued MRI- or CT-examinations, with negative consequences for patient experience, workflow, treatment and cost. To reduce this anxiety to manageable proportions, psychological interventions appear to be more effective than mere information provision or technological improvements. Two case studies illustrate the impact of different approaches in anxiety reduction, supporting the results of a retrospective study of 68 patients. Here, 74% of patients successfully completed an MRI or CT scan after personalized eclectic treatment. For most patients, one or two treatment sessions were sufficient.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Unfounded objections against the use of salbutamol/ipratropium]. [毫无根据的反对使用沙丁胺醇/异丙托品]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-06-30
Eliane A Lucassen, Ragna Rood, Jeroen Tibboel, Sebastiaan R D Piers
{"title":"[Unfounded objections against the use of salbutamol/ipratropium].","authors":"Eliane A Lucassen, Ragna Rood, Jeroen Tibboel, Sebastiaan R D Piers","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In acute bronchospasm due to asthma/COPD exacerbations two bronchodilators are frequently used: ipratropium, an acetylcholine antagonist, and salbutamol, a β2-agonist. The combination ipratropium/salbutamol gives more bronchodilation than ipratropium monotherapy in asthma/COPD exacerbations, but there are concerns about cardiac safety of salbutamol. Salbutamol in regular dosage does not affect heart rate in diverse populations (ED, ICU and children). Only a dosage 5-10x the standard dosage of 2,5 mg leads to a 20-30-beat increase in heart rate. High-dose salbutamol induced a mild increase of QTc interval (±360 to ±390ms) and QTc dispersion (maximum minus minimum QTc; marker for susceptibility to arrhythmia), but not to a clinically relevant extent. Most importantly, literature shows that the incidence of arrhythmia is similar between salbutamol and placebo. Salbutamol did not induce severe arrhythmias, including in arrhythmogenic ICU populations or in patients with severe COPD with cardiac comorbidity. We therefore argue that the current caution exercised with the use ipratropium/salbutamol is unjustified. Treatment should not be withheld in case of tachycardia or underlying heart disease.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Myxedema psychosis, a rare complication of untreated hypothyroidism]. [黏液性水肿精神病，未经治疗的甲状腺功能减退的罕见并发症]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-06-26
Maaike A Speelman, Gerlinde G L Haverkamp
{"title":"[Myxedema psychosis, a rare complication of untreated hypothyroidism].","authors":"Maaike A Speelman, Gerlinde G L Haverkamp","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Myxedema psychosis, also known as myxedema madness, is a rare neuropsychiatric manifestation of untreated or inadequately treated hypothyroidism. We report the case of a 46-year-old woman presenting to the emergency department with acute psychiatric symptoms, including confusion, hallucinations, and delusions. Physical examination revealed classic signs of hypothyroidism, such as periorbital edema, dry skin, and diffuse hair loss. Laboratory results showed a markedly elevated thyroid-stimulating hormone (TSH) level of 45.76 mU/L and a severely reduced free thyroxine (T4) level (< 1.0 pmol/L), confirming the diagnosis of myxedema psychosis. Intravenous administration of levothyroxine and liothyronine (T3) led to rapid resolution of psychotic symptoms. This case report underscores the critical need to evaluate somatic causes, including hypothyroidism in patients presenting with acute psychiatric symptoms. Timely diagnosis and appropriate thyroid hormone replacement therapy can result in full recovery.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"D169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[A man with a skin lesion on his buttocks]. [臀部有皮肤损伤的男子]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-06-25
Donald R Romijn, Evelien E de Vries, Annemarije Braber
{"title":"[A man with a skin lesion on his buttocks].","authors":"Donald R Romijn, Evelien E de Vries, Annemarije Braber","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 51-year old male with an altered consciousness was presented to the hospital after ingestion of unknown quantities of medication, alcohol and turpentine. During examination, erythematous buttocks were noticed and first degree decubitus was suspected. The following day second degree burns on his buttocks and thighs were noticed.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Unused medical disposables in the operating room: frequency, carbon footprint, and opportunities for sustainable healthcare]. [手术室中未使用的一次性医疗用品：频率、碳足迹和可持续医疗保健的机会]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-06-24
Lisa van Bodegraven, Remko M van Eenennaam, Lisanne H J A Kouwenberg, Eva S Cohen, Niek H Sperna Weiland, Wouter J K Hehenkamp, Dorien A Salentijn
{"title":"[Unused medical disposables in the operating room: frequency, carbon footprint, and opportunities for sustainable healthcare].","authors":"Lisa van Bodegraven, Remko M van Eenennaam, Lisanne H J A Kouwenberg, Eva S Cohen, Niek H Sperna Weiland, Wouter J K Hehenkamp, Dorien A Salentijn","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>This study quantifies and characterizes unused medical disposables in operating rooms to determine their carbon footprint and identify opportunities for sustainable improvements in healthcare.</p><p><strong>Design: </strong>Observational study.</p><p><strong>Method: </strong>The study was conducted at Amsterdam University Medical Centre, a tertiary hospital with 44 operating rooms. Unused disposables from surgeries conducted during office hours were collected for two weeks. The number, weight and volume of the disposables were determined for each surgery. The carbon footprint was calculated based on data from a Life Cycle Assessment.</p><p><strong>Results: </strong>1785 unused disposables were identified from 187 surgeries, with a carbon footprint of 338 kg CO2-equivalents (kg CO2-eq) and weighing 60 kg. Gauze (37 kg CO2-eq) and surgical drapes (127 kg CO2-eq) were found to have the largest carbon footprints, with gauze contributing substantially due to their frequent waste (n = 527; weight = 3 kg) and drapes due to their weight (n = 154; weight = 15 kg).</p><p><strong>Conclusion: </strong>Unused disposables in operating rooms cause waste and a substantial carbon footprint.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Large language models in healthcare]. [医疗保健中的大型语言模型]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-06-24
Bram Van Es, Karin R Jongsma, Saskia Haitjema
{"title":"[Large language models in healthcare].","authors":"Bram Van Es, Karin R Jongsma, Saskia Haitjema","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Large language models, AI-based models that can generate language and which are optimized for human interaction, are widely available and also offer opportunities for healthcare. Yet, they also raise important questions about their quality and ethical-legal issues. This article answers ten questions about the use of large language models in healthcare.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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