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[Selection of trainees for medical specialties; time for a different approach]. [医学专业培训生的选拔；是时候换个方法了]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-09-10
Petra C A M Bakker, Wim J R R Rietdijk, Halima Kharrat, Janneke K Oostrom
{"title":"[Selection of trainees for medical specialties; time for a different approach].","authors":"Petra C A M Bakker, Wim J R R Rietdijk, Halima Kharrat, Janneke K Oostrom","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Selection procedures for medical specialty training positions shape the future quality and composition of the specialist workforce. Yet selection often relies on opaque, bias-prone tools such as motivation and reference letters, CVs and unstructured interviews. These methods are hard to compare, may promote similarity-based decisions, and disadvantage applicants with limited access to the \"hidden curriculum\". We argue that current practice is increasingly unjustifiable and propose a structured, evidence-informed alternative, aligned with principles of fairness, transparency and predictive validity. Key elements include predefined competency domains, a standardized anonymized application form, rubric-based assessment, and structured interviews with independent scoring. Importantly, assessment can be done by a committee of up to six members without loss of reliability, while improving efficiency. Finally, we argue that merit should extend beyond research output, explicitly valuing clinical performance, teaching, leadership, innovation and societal impact.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982936","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 young woman with a tumor on the finger]. [手指上有肿瘤的年轻女子]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-09-09
Ine F L Romaen, Lotte Voeten, Peter M Steijlen
{"title":"[A young woman with a tumor on the finger].","authors":"Ine F L Romaen, Lotte Voeten, Peter M Steijlen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 37-year old female presented with a painless tumor on the proximal interphalangeal joint of the left index finger. Clinical evaluation showed a solitary exophytic keratotic tumor with mildly elevated borders. Histopathological examination after radical surgical excision confirmed the clinical diagnosis: acral fibrokeratoma.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982987","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
[Epstein-Barr virus infection; many clinical pictures, often relevant to consider]. eb病毒感染；许多临床图片，往往相关考虑]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-09-08
Eleanor Gee, Jacomijn van Mameren, Ernst-Jan van 't Wout, Fanny Lauw
{"title":"[Epstein-Barr virus infection; many clinical pictures, often relevant to consider].","authors":"Eleanor Gee, Jacomijn van Mameren, Ernst-Jan van 't Wout, Fanny Lauw","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Epstein-Barr virus (EBV) infections are prevalent, usually occurring asymptomatically at a young age. The classic clinical presentation of acute EBV infection is characterized by fever, throat pain and lymphadenopathy. In this article we demonstrate the broad range of EBV presentations using three case studies; the classic presentation but also hemolyticanemia or as a result of EBV. We hope to illustrate the importance of early identification of the disease and the impact this can have on diagnostic and treatment plans. Specifically, including EBV in the differential diagnosis of various clinical presentations can sometimes avoid costly and invasive examinations towards an underlying cause.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982995","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
[The surgical treatment of scapular fractures]. 肩胛骨骨折的外科治疗。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-08-31
Vina Kruithof, Niels W L Schep
{"title":"[The surgical treatment of scapular fractures].","authors":"Vina Kruithof, Niels W L Schep","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Scapular fractures are predominantly managed non-operatively. However, a subset of patients develops persistent pain, weakness, and functional impairment due to malunion, non-union, rotator cuff dysfunction, or scapulothoracic dyskinesia. Early identification of patients at risk for ongoing symptoms is essential, as timely surgical intervention may improve outcomes. Owing to the lack of randomized controlled trials comparing operative and non-operative management, surgical indications remain controversial. This article reviews the biomechanics of the scapula, mechanisms of injury, fracture types, and current operative indications. Two clinical cases are presented to illustrate decision-making in operative versus non-operative treatment. While selected patients benefit from surgical fixation with good long-term functional outcomes, evidence indicates that both treatment strategies can achieve high union rates when appropriately individualized.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148830568","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
[Marchiafava-Bignami disease: an alcoholic with reduced consciousness and muscle paratonia]. [Marchiafava-Bignami病：伴有意识减退和肌肉张力异常的酗酒者]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-08-26
Linda C H H Christiaans, Ype de Jong, Julia N A Mangione, Mojca K M van Schie
{"title":"[Marchiafava-Bignami disease: an alcoholic with reduced consciousness and muscle paratonia].","authors":"Linda C H H Christiaans, Ype de Jong, Julia N A Mangione, Mojca K M van Schie","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 69-year-old man presented with decreased consciousness and a puzzling muscle paratonia. MRI showed extensive white matter abnormalities with diffusion restriction in the corpus callosum, consistent with Marchiafava-Bignami disease, a rare complication of chronic alcohol abuse. The phenomenon of paratonia should have raised a clinical suspicion towards endstage neurodegenerative disease.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148830626","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
[Herbs, vitamins, and minerals during anticancer treatment]. [抗癌治疗中的草药、维生素和矿物质]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-08-24
Lotte Stevens, A M Peters van Ton, Marieke Berends, Hanneke W H A Fleuren, Art Vreugdenhil, A M van Dulmen, Kees Kramers
{"title":"[Herbs, vitamins, and minerals during anticancer treatment].","authors":"Lotte Stevens, A M Peters van Ton, Marieke Berends, Hanneke W H A Fleuren, Art Vreugdenhil, A M van Dulmen, Kees Kramers","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Over 40% of cancer patients use supplements, such as herbs, vitamins, and minerals, while undergoing anticancer treatment. Patients often take these supplements because they assume they improve overall health, reduce side effects, or correct deficiencies. However, these products may carry risks, including pharmacokinetic or pharmacodynamic interactions with anticancer drugs. We present an overview of potential interactions between commonly used supplements and anticancer therapies, which can assist clinicians in evaluating their safety. Communication between clinicians and patients about herbs, vitamins, and minerals is often limited. Clinicians should proactively inquire about patients' expectations and needs regarding both conventional therapies and herbs, vitamins, or minerals. By initiating these discussions and making balanced, shared decisions, clinicians can help ensure the efficacy and safety of anticancer therapies while maintaining patients' trust.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148830646","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
[Migrants as 24/7 caregivers?] [移民是全天候看护人？］
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-08-20
Sjaak J D M van der Geest
{"title":"[Migrants as 24/7 caregivers?]","authors":"Sjaak J D M van der Geest","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Anthropological research on formal and informal migrant caregivers for the elderly in Italy shows how the government welcomes or tolerates these migrants because they are indispensable in Italy, where the imbalance between fertility and aging places great pressure on families with dependent (grand)parents. The presence of migrant caregivers in the country is very high, as it is in several other, primarily southern European countries. The question is whether such a (possibly adjusted) contribution from migrants is also possible and desirable in the Netherlands. Currently, the contribution of migrants to healthcare in general is lower in the Netherlands than in neighboring countries. This contribution does not focus on professional healthcare, but on in-home, 24/7 elderly care, which primarily consists of companionship, supervision, and household tasks for elderly people who can no longer live independently and for whom family members cannot provide the necessary care.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795822","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 teenager with chest pain]. [胸痛的青少年]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-08-19
Nadie H M Bosmans, Annette P M Van den Elzen, Wout O Boom
{"title":"[A teenager with chest pain].","authors":"Nadie H M Bosmans, Annette P M Van den Elzen, Wout O Boom","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 14-year-old boy developed acute chest pain after exertion without trauma. Imaging showed pneumomediastinum and pneumopericardium. He was admitted due to tamponade risk. Symptoms resolved spontaneously. This case shows spontaneous pneumopericardium can occur in healthy adolescents, and in the absence of tamponade signs, a conservative 'watchful waiting' approach is appropriate.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"70 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795833","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
[The alarm sounds, but there is no fire]. [警铃响了，但没有火]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-08-19
Kees van Boven, Peter Lucassen, Tim C Olde Hartman, Omer Van den Bergh
{"title":"[The alarm sounds, but there is no fire].","authors":"Kees van Boven, Peter Lucassen, Tim C Olde Hartman, Omer Van den Bergh","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Many physical complaints cannot be explained by tissue damage or disease. The predictive-coding model describes the brain as an active predictive system that interprets signals based on expectations and actual input. Complaints arise from a dynamic interplay between predictions and signals, influenced by emotions, trauma, culture, and context. Strong expectations of symptoms can override actual signals, causing complaints to often persist after recovery. This explains also interindividual differences, discrepancies with objective findings, and the effect of psychological interventions. The model integrates biology, psychology, and context, and provides physicians with a framework to normalize complaints, and emphasizes diagnostics and integrated treatment.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795799","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
[Medical trauma]. (医疗创伤)。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-08-18
Marian E Rikkert, Chantal van Kempen
{"title":"[Medical trauma].","authors":"Marian E Rikkert, Chantal van Kempen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Medical trauma refers to psychological symptoms that arise as a result of medical conditions or medical treatments. Although medical interventions are intended to promote healing, they may evoke feelings of powerlessness, fear, and loss of control in some patients, potentially leading to symptoms of PTSD or even PTSD. These reactions can occur in both children and adults and often go unrecognized or are misattributed to normal stressreactions or the recovery process. Several factors influence the development of medical trauma and its psychological consequences. Early recognition by physicians is essential. Greater awareness in clinical practice is crucial, as is appropriate referral for evidence-based psychological treatment. In this article, we use clinical cases to illustrate how to recognize medical trauma in adults, how preventive strategies can reduce risk, and which evidence-based treatments are available.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"D8934 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795801","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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