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[Less iron deficiency in whole-blood donors: the effect of ferritin-guided donation intervals]. [全血献血者较少缺铁：铁蛋白引导的献血间隔的影响]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2024-12-31
Amber Meulenbeld, Steven Ramondt, Maaike G Sweegers, Franke A Quee, Femmeke J Prinsze, Emiel O Hoogendijk, Dorine W Swinkels, Katja van den Hurk
{"title":"[Less iron deficiency in whole-blood donors: the effect of ferritin-guided donation intervals].","authors":"Amber Meulenbeld, Steven Ramondt, Maaike G Sweegers, Franke A Quee, Femmeke J Prinsze, Emiel O Hoogendijk, Dorine W Swinkels, Katja van den Hurk","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effect of ferritin-guided donation intervals on haemoglobin (Hb) and ferritin levels, iron deficiency and low Hb deferrals in whole-blood donors.</p><p><strong>Design: </strong>A cluster-randomized stepped-wedge trial.</p><p><strong>Methods: </strong>In 2017-2019, Sanquin gradually implemented ferritin-guided donation intervals. Ferritin levels are measured in new donors and at every fifth donation. Donors with ferritin levels ≤ 30 ng/mL are deferred for 6-12 months. Additionally, we assessed donor return within six months.</p><p><strong>Results: </strong>In the 36 months following the implementation of the policy, the percentage of donors with iron deficiency, low ferritin, and low Hb decreased. Additionally, Hb and ferritin levels increased significantly compared to the previous policy. In males, odds of return decreased significantly after implementation of the new policy.</p><p><strong>Conclusion: </strong>Ferritin-guided donation intervals effectively improve donors' iron status, but necessitate additional efforts in donor recruitment and retention.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"8 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877587","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
[Joint preserving treatments of the knee]. [膝关节的保关节治疗]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2024-12-30
Laury Angenent, Ralph M Jeuken, Jacob J Caron, Roel J H Custers, Hugo C van der Veen, Pieter J Emans
{"title":"[Joint preserving treatments of the knee].","authors":"Laury Angenent, Ralph M Jeuken, Jacob J Caron, Roel J H Custers, Hugo C van der Veen, Pieter J Emans","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Middle-aged patients with early onset arthritis or cartilage defects are difficult to treat. These patients are relatively young for joint replacement and relatively old for regenerative therapies, i.e.: a treatment gap. Therefore, the concept of joint preservation has emerged with the main goal to delay of even prevent joint replacement. Several novel surgical techniques and treatment algorithms for cartilage repair are developed. New insights show that knee joint preservation is best achieved by combining treatments, for instance cartilage repair and mechanical (alignment) correction. Since combining different surgeries introduces more complexity, a guideline has been drafted, which states that (part of) this care is perhaps best centralised. It is therefore important, to treat patients eligible for joint preservation in collaboration with expert centres. This brief clinical lesson provides the latest insights in the Dutch knee joint preservation care supported by the latest guideline.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"168 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877573","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
[Interpretation of research on patient volumes]. [对患者数量研究的解释]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2024-12-26
Rolf H H Groenwold, Arno A W Roest, Frits R Rosendaal
{"title":"[Interpretation of research on patient volumes].","authors":"Rolf H H Groenwold, Arno A W Roest, Frits R Rosendaal","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Healthcare research into patient volumes and volume-outcome relations can have far-reaching consequences. By means of a thought experiment, five core elements of valid research into patient volumes are identified: variation in numbers of patients, scalability of capacity, comparability regarding quality of care, comparability regarding groups of patients, and statistical precision. Practical challenges are described for each of these aspects as well as their possible impact on research quality. This is illustrated using the example of volume-outcome relations in the field of pediatric cardiac surgery.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"168 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877523","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
[Schwannoma, a rare swelling of the tongue]. [神经鞘瘤，一种罕见的舌头肿胀]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2024-12-25
Tim Van Cleemput, Andy van Veen, Bram van Loon
{"title":"[Schwannoma, a rare swelling of the tongue].","authors":"Tim Van Cleemput, Andy van Veen, Bram van Loon","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 65-year-old woman presented with progressively increasing swelling on the right lateral side of her tongue. Further investigation confirmed it to be a schwannoma. Surgical excision of the tumour was performed, resulting in an uncomplicated postoperative recovery with complete preservation of the tongue function.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"168 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877580","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 evaluation of a patient with eosinophilia]. [嗜酸性粒细胞增多症患者的评估]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2024-12-24
Luuk A J van Gils, Hilde H F Remmelts, Rob Fijnheer, E C Hagen, Gerald H A Staaks
{"title":"[The evaluation of a patient with eosinophilia].","authors":"Luuk A J van Gils, Hilde H F Remmelts, Rob Fijnheer, E C Hagen, Gerald H A Staaks","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Eosinophilia is a common laboratory finding with a broad differential diagnosis. Eosinophilia can be classified as primary, secondary, or idiopathic hypereosinophilic syndrome (HES). Primary eosinophilia results from a clonal disorder of eosinophils, while secondary eosinophilia is reactive to a variety of underlying conditions, such as allergic diseases, infections, and drug reactions. Idiopathic HES is a diagnosis of exclusion in patients with persistent hypereosinophilia and end-organ damage without an identifiable cause. The diagnostic workup should focus on identifying the cause and assessing for end-organ damage. The initial evaluation should include a detailed history and physical examination, and laboratory tests to assess for organ involvement. Further testing may be necessary based on the clinical presentation and laboratory findings. The treatment depends on the cause. In cases of secondary eosinophilia, treatment should be directed at the underlying condition.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"168 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877584","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
[Quick decisionmaking for acute pulmonary embolism patients]. [急性肺栓塞患者快速决策]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2024-12-23
Linde J Op de Hoek, Jose M Montero Cabezas, Paul L den Exter, Ibtihal Al Amri, Carlos V Elzo Kraemer, F A Klok
{"title":"[Quick decisionmaking for acute pulmonary embolism patients].","authors":"Linde J Op de Hoek, Jose M Montero Cabezas, Paul L den Exter, Ibtihal Al Amri, Carlos V Elzo Kraemer, F A Klok","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Treatment options for patients with severe pulmonary embolism (PE) have increased substantially over the past decade. Although systemic thrombolysis is still the reperfusion therapy of choice for hemodynamically unstable PE patients, several new catheter guided reperfusion therapies have emerged as possibly safer alternatives. These therapies are increasingly implemented in clinical practice even though their efficacy and safety are yet to be proven by clinical outcome studies. Along with the rise of new interventional therapies has come the introduction of multidisciplinary Pulmonary Embolism Response Teams (EXPERT-PE, referred to as PERT in the United States), composed of multidisciplinary experts involved in treating acute PE. The EXPERT-PE concept provides a multidisciplinary and rapid platform for deciding on an individualized treatment strategy in an era of rapidly developing advanced treatment options, combining expert opinion from all involved specialties and forming the base for future research in PE care.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"168 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877577","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
[Customised care and appropriate care: keep them crisp]. [定制护理和适当护理：保持清爽]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2024-12-18
E Hoogerwerf, Stefan M van Geelen, Annet van Royen-Kerkhof
{"title":"[Customised care and appropriate care: keep them crisp].","authors":"E Hoogerwerf, Stefan M van Geelen, Annet van Royen-Kerkhof","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Inconsistent use of the Dutch terms 'zorg op maat' (customised care) and 'passende zorg' (appropriate care) in healthcare-, policy- and political discourse in the Netherlands makes them unclear umbrella terms and causes confusion and annoyance among many involved. 'Zorg op maat' and 'passende zorg', originally meant 'providing care according to the wishes and care-related possibilities of the individual patient', but now mainly concern the approaching financial limits of the healthcare-system. 'Passende zorg' has also become a key concept in the marketing strategy of healthcare organizations as a management instrument. Many (bedside)healthcare providers now see 'passende zorg' as a euphemism for financial cutbacks. The authorsaim to create awareness about the use of these terms to prevent incorrect expectations and irritation. Fresh names for new policies or financially feasible care ensure a transparent process and less complicated implementation.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"168 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854921","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
[Early detection of alcohol use: discuss alcohol use to prevent damage]. [早期发现酒精使用：讨论酒精使用以防止损害]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2024-12-17
Merel van Loon-van Gaalen, H J M de Jonge, Petra Ooms
{"title":"[Early detection of alcohol use: discuss alcohol use to prevent damage].","authors":"Merel van Loon-van Gaalen, H J M de Jonge, Petra Ooms","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Health professionals do not routinely ask patients about alcohol use, although it is associated with a range of somatic and psychological problems. Therefore, alcohol use may not be recognized as the cause of a health problem, which may result in worsening of the situation, incorrect diagnosis or incorrect treatment. This is illustrated by three cases from different clinical practices: the emergency department, the hospital ward and the general practice.</p><p><strong>Barriers: </strong>Several factors, such as time limitations and provider beliefs, can hinder asking about and discussing alcohol use.</p><p><strong>Importance of early detection: </strong>By discussing alcohol use, patients with alcohol-related problems can receive information and guidance to prevent further harm. Motivational interventions can be effective, but shorter interventions, such as a short feedback conversation, can also contribute to awareness and change in alcohol consumption. Adequate registration and hand-over, and referral and follow up agreements between institutions can improve continuity of care.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"168 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854923","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
[Burns]. (燃烧)。
Nederlands tijdschrift voor geneeskunde Pub Date : 2024-12-17
Ymke Lucas, C H van de Vlies, Eelke Bosma, Karina Hilarides-Streunding, Paul P M van Zuijlen, Annebeth Meij-de Vries
{"title":"[Burns].","authors":"Ymke Lucas, C H van de Vlies, Eelke Bosma, Karina Hilarides-Streunding, Paul P M van Zuijlen, Annebeth Meij-de Vries","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In the Netherlands, an average of 92,000 patients with burn injuries are seen annually by a general practitioners. A burn injury is defined as skin damage caused by heat, radiation, electricity, and/or chemical agents. It is crucial to make an accurate assessment of the severity of the burn. The severity is primarily determined by the size (also referred to as the total burned body surface area, or TBSA), the depth of the burn, as well as the location, any associated injuries (such as inhalation trauma) and patient factors such as age and comorbidities. What initial measures do you take, what should you pay attention to, what treatment do you administer and when is it necessary to contact one of the three burn centers? This article will provide more clarity on these questions.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"168 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854918","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 key role for physicians in identifying, discussing and referring problematic alcohol use]. [医生在识别、讨论和转诊问题酒精使用方面的关键作用]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2024-12-12
Ninette E van Hasselt, Rob H L M Bovens, Carmen V Voogt, W J J Assendelft
{"title":"[A key role for physicians in identifying, discussing and referring problematic alcohol use].","authors":"Ninette E van Hasselt, Rob H L M Bovens, Carmen V Voogt, W J J Assendelft","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Alcohol consumption increases the risk of approximately 200 health conditions. Nature, severity, and prevalence of alcohol-related issues in the Netherlands warrant more structured attention in medical consultations. Over 20 GP-guidelines recommend addressing alcohol consumption and providing advice. However, only severe alcohol-related issues are commonly addressed in the consultation room.</p><p><strong>Method: </strong>Based on scientific literature challenges and opportunities are outlined.</p><p><strong>Results: </strong>Physicians are key figures in the (early) detection of problematic alcohol use, but addressing this often proves difficult and is mostly limited to cases of (suspected) severe alcohol problems. Discomfort with the topic, underestimation of the issue, and unfamiliarity with referral options play a significant role.</p><p><strong>Discussion: </strong>By briefly addressing alcohol use, inquiring about amount and frequency of consumption, implementing evidence-based short interventions, and referring to on- and offline prevention services from addiction care, physicians can contribute to the prevention and reduction of risky drinking.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"168 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807680","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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