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[A parasitic infection as an unwanted souvenir].
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-02-24
Neill Boeijink, Maurits Lange, Colette L M van Hees
{"title":"[A parasitic infection as an unwanted souvenir].","authors":"Neill Boeijink, Maurits Lange, Colette L M van Hees","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 27-year-old patient came to the dermatology outpatient clinic of the Erasmus MC because of progressive swelling, pain, itching and skin lesions of the left foot for two days. The symptoms initially started with erythematous urticarial papules and vesicles. After a day severe swelling of the forefoot, bullae around the toes and several slowly progressive serpiginous plaques developed without systemic complaints. A week before the onset of the symptoms, he had returned from a trip to Colombia. Under the working diagnosis of cutaneous larva migrans, ivermectin 0.2 mg/kg for two consecutive days, clobetasol, cetirizine and local compression therapy were started. Two weeks after the start of the treatment, the patient was symptom-free. The disease is self-limiting. In case of multiple lesions or severe reaction, treatment may be considered.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516244","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 treatment of intolerance for enteral nutrition of unknown origin with parenteral nutrition].
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-02-18
Julia W Korzilius, Gerard Dijkstra, Daniel Keszthelyi, Thom J van den Heuvel, Mireille J Serlie, Geert J A Wanten
{"title":"[The treatment of intolerance for enteral nutrition of unknown origin with parenteral nutrition].","authors":"Julia W Korzilius, Gerard Dijkstra, Daniel Keszthelyi, Thom J van den Heuvel, Mireille J Serlie, Geert J A Wanten","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In recent years, there has been a notable rise in referrals to specialised chronic intestinal failure centres of patients with self-reported intolerance to enteral feeding. Despite incomplete or inconclusive diagnostic procedures and no convincing clinical evidence for the presence of intestinal failure, patients often urge physicians to start with total parenteral nutrition (TPN). The frequent use of opioids in these patients is a complicating factor concerning the diagnostic workup for motility disorders and the interpretation of clinical symptoms. Despite TPN administration, these patients continue to pose a significant burden to medical staff and hospital resources because of persistent complaints, no improvement in quality of life and the occurrence of severe life-threatening complications. Therefore, we strongly advise against initiating TPN in patients with intolerance for enteral nutrition who are not diagnosed with intestinal failure. Instead, we encourage our colleagues to consult an expert centre and engage a mental healthcare professional early.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458673","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
[Depression].
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-02-18
Peter Lucassen, Jan Spijker
{"title":"[Depression].","authors":"Peter Lucassen, Jan Spijker","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Feeling down is notalways a symptom of depressive disorder. Mostly the feeling is understandable in the light of the circumstances. The first approach should be a good conversation about what is happening, about the patient's aims and possibilities: the person-centered approach. However, when the patient has recurrent depressive episodes, has severe limitations in functioning or periods of mania, then the disease-centered approach is necessary, resulting in diagnosing depressive disorder (or bipolar disorder) and treating the patient according to the guidelines. In primary care, systematic screening of suicidality in depressed patients is not effective; case-finding is the preferred strategy.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458670","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 patient refuses treatment. What to do now?]
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-02-17
Aart C Hendriks, Wouter de Ruijter
{"title":"[The patient refuses treatment. What to do now?]","authors":"Aart C Hendriks, Wouter de Ruijter","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Treating a patient requires his or her informed consent. The Dutch Medical Treatment Contracts Act (WGBO), however, contains three exceptions in which cases permission from the patient is not required. In emergency cases a physician is allowed to treat an incompetent patient, even against his or her will. The treating physician can both be a general physician or an emergency physician in a hospital considering to treat a patient against serious somatic injuries or threats. As long as the patient is incompetent and the emergency situation continues a physician is not required to invite the crisis intervention team to assess the competence of the patient and the potential harm the patient's condition may cause under the Compulsory Mental Healthcare Act (WVGGZ). In fact, more care may be provided than initially considered essential to save the life of the patient as long as the emergency situation lasts. However, the longer the emergency situation exists, the more necessary it becomes to involve the crisis intervention team and ask for a crisis measure for the patient under the WVGGZ.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458672","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
[Handling fear of cancer recurrence].
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-02-13
Chris Hinnen, Aart Beeker, Justine Kuiper, Jony Bruin
{"title":"[Handling fear of cancer recurrence].","authors":"Chris Hinnen, Aart Beeker, Justine Kuiper, Jony Bruin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Some fear of cancer recurrence is normal and may even be adaptive. However, high levels of anxiety may become problematic as it often results in for example sleeping problems, rumination, avoiding (incl. medical appointments) and/or physical complaints. For general practitioners and specialists it is important to recognizing this fear, discuss and ask questions about it and know how to intervene and refer. Validation and psychoeducation may be sufficient when fear is relatively low and manageable. When fear starts to interfere with normal life referral to a psychologist in the hospital or specialized mental health services for an evidence based treatment may be appropriate.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399523","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
[Abstinence or controlled alcohol consumption?]
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-02-13
Michiel Gravesteijn, Willem Baijens, Robert Meijburg, Elianne van Hoogdalem
{"title":"[Abstinence or controlled alcohol consumption?]","authors":"Michiel Gravesteijn, Willem Baijens, Robert Meijburg, Elianne van Hoogdalem","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Disorders in alcohol consumption are among the most common, having the highest impact on morbidity and mortality, in mental health care. Treatment strategies differ greatly between institutions and the aim for controlled alcohol consumption remains controversial. The risk of (somatic) complications of alcohol abuse increase with a higher quantity of consumption, however there is no clear threshold regarding the development of certain health issues due to numerous factors determining individual susceptibility. Problematic alcohol abuse is treated either by aiming for complete abstinence, abstinence for the duration of therapy or controlled alcohol consumption. Considering a medical perspective aiming for abstinence in alcohol consumption is preferred, which however results in large amounts of untreated patients and limited effectivity. In our opinion, this advocates for a role of controlled alcohol consumption as 'harm reduction', focusing on the perspective of personal and communal recovery.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399546","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
[Gender differences in career paths in medical academia: a nationwide study in the Netherlands].
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-02-11
Silvan Licher, Daphne L van Helden, Margot M Weggemans, Coen B J van Deursen, Bas Holverda, Michiel van der Vaart, Miranda Wijdenes, Meike W Vernooij, Frank J Wolters
{"title":"[Gender differences in career paths in medical academia: a nationwide study in the Netherlands].","authors":"Silvan Licher, Daphne L van Helden, Margot M Weggemans, Coen B J van Deursen, Bas Holverda, Michiel van der Vaart, Miranda Wijdenes, Meike W Vernooij, Frank J Wolters","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To determine gender differences in career progression of physicians.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Method: </strong>We examined career progression until 2023 of 715 physicians who received their PhD in the Netherlands in 2007/2008. We also pooled data from 7 national grant programs from 2005 up until Jan 1, 2023.</p><p><strong>Results: </strong>Fifteen years after their PhD defence, 43% of physicians worked in academia, similar for men and women. Men published more than women (9[3-27] vs. 6[2-15] publications; p=0.001), especially in academia. Women were less likely than men to be appointed full professor (10/330 vs. 27/385; odds ratio[95% CI]: 0.41[0.20-0.87]), which was mediated for 55% by their number of scientific publications. Women increasingly applied for research grants over time, with an equal number of women and men receiving 'early career' grants since 2015. More men applied for 'established investigator' grants, without any gender differences in award rates.</p><p><strong>Conclusion: </strong>Career perspectives in the early phase after obtaining a PhD, including grant allocation, are similar for male and female physicians. Differences in their later career phase were partly related to a higher number of scientific publications by men, compared to women.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399516","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
[Automatic formula dispensers, relief or risk?]
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-02-04
Ilse Bel, Justus M Maier, Sanne de Kreij, Richard A van Lingen
{"title":"[Automatic formula dispensers, relief or risk?]","authors":"Ilse Bel, Justus M Maier, Sanne de Kreij, Richard A van Lingen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The usage of automatic formula dispensers comes with certain risks which are commonly unknown to parents and caregivers. In this article we describe two cases in which incorrect usage of these dispensers resulted in health issues. In one case the usage of a formula dispenser resulted in failure to thrive and in the other case it resulted in prolonged abdominal pain. These two cases emphasize the importance of extensive history taking regarding nutrition in cases with failure to thrive or nutritional difficulties. Caregivers should be aware of the potential risks associated with automatic formula dispensers. Furthermore, it is of importance to provide comprehensive guidance to parents regarding the correct utilization of these dispensers.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255845","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
['More research is needed' is a meaningless conclusion]. （‘需要更多的研究’是一个毫无意义的结论）。
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-01-28
Yvo M Smulders, Jonne J Sikkens
{"title":"['More research is needed' is a meaningless conclusion].","authors":"Yvo M Smulders, Jonne J Sikkens","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This sentence often concludes medical research articles. We argue that 'more research is needed' is an empty phrase. There is always room for synthesis of previously existing and currently added knowledge, allowing for a conclusion on what we now know. Surely, current knowledge is rarely definitive. Sometimes it is, however, in which case valuable resources are better spent elsewhere, rather than in more research on the topic of interest.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008643","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
[Should we all do mouth taping? The real story behind breathing through the nose.]
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-01-23
Digna M A Kamalski
{"title":"[Should we all do mouth taping? The real story behind breathing through the nose.]","authors":"Digna M A Kamalski","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Breathing through the nose has many benefits compared to mouth breathing. There are ways to force breathing through the nose, for instance by mouth taping. It is, however, normal that nasal passage variates. This article describes the normal physiologic variations in nasal breathing. Mouth taping is not needed to change it!</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255849","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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