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[Severe hypertension in primary care or emergency departments: avoid unnecessary referrals or additional diagnostics]. [严重高血压在初级保健或急诊科：避免不必要的转诊或额外的诊断]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-04-07
Job van Steenkiste, Joost H W Rutten, Sabine C Käyser, Bert-Jan H van den Born, Jorie Versmissen
{"title":"[Severe hypertension in primary care or emergency departments: avoid unnecessary referrals or additional diagnostics].","authors":"Job van Steenkiste, Joost H W Rutten, Sabine C Käyser, Bert-Jan H van den Born, Jorie Versmissen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Severe hypertension is a common reason to visit the General Practitioner (GP) or Emergency Department (ED) and accounts for 1-2% of all ED visits in the Netherlands. In 2021 a new national guideline 'Hypertensive emergency' was developed. In practice, however, a large variability with regards to referrals and additional diagnostics still exists. Here, we present three exemplary cases presenting to the GP or ED with severe hypertension. Based on the current guideline, we suggest that initial presenting complaints should guide the physician's choice for referral and additional diagnostics instead of the blood pressure reading. Patients with a high blood pressure and symptoms pointing towards acute hypertensive organ damage (e.g., chest pain, acute dyspnea) should always be referred to the ED, while. patients with headache or visual disturbances alone should only be referred if the blood pressure exceeds 200/120 mmHg.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025241","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
[Intoxication with a nitazene; new potent synthetic opioids on a rise]. [nitazene中毒；新型强效合成阿片类药物正在增加。
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-04-03
Rhett Balster, Laura Hondebrink, Thomas T Boel, Bas van de Velde, Paul D van der Linden, Madelon H Butterhoff-Terlingen
{"title":"[Intoxication with a nitazene; new potent synthetic opioids on a rise].","authors":"Rhett Balster, Laura Hondebrink, Thomas T Boel, Bas van de Velde, Paul D van der Linden, Madelon H Butterhoff-Terlingen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Nitazenes, a class of highly potent synthetic opioids, have emerged as a significant public health concern in Europe. This highly potent opioid can cause severe, potentially life-threatening intoxications even at small dosages. This case describes the first nitazene intoxication reported in the Netherlands, specifically with isotonitazepyne. We present a case of a 60-year-old male with a history of substance use disorder, who experienced respiratory and cardiac arrest after nasally ingesting self-prepared isotonitazepyne. Prompt administration of naloxone reversed respiratory depression, and the patient fully recovered. Nitazene intoxications resemble opioid toxicity but tend to have a more severe course due to their high potency. Treatment involves supportive care and naloxone. Increased awareness of nitazenes is crucial as their presence in Europe grows. This report highlights the clinical presentation and management of a nitazene overdose and the importance of vigilance, reporting, and collaboration for managing emerging psychoactive substances effectively.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795778","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
[Lung function and ethnicity: comments on race-neutral reference equations]. [肺功能和种族：对种族中立参考方程的评论]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-04-01
Joost G van den Aardweg
{"title":"[Lung function and ethnicity: comments on race-neutral reference equations].","authors":"Joost G van den Aardweg","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Recently, race-neutral reference equations have been published for spirometry, based on a large international reference population ('Global Lung Initiative'). Analysis of demographic data in the USA shows that this may have negative consequences for some groups, compared with race-specific reference equations. De underlying question remains whether ethnic differences exist in lung function. Most measurements have been performed in people of North-European ancestry and are therefore probably not representative for the rest of the world. A more representative study is warranted. Ideally, we can find out which factors determine possible differences between ethnic groups, so that spirometry values can be corrected for these factors.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795784","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
[Orbital foreign body in a child; think of underlying injury in not observed penetrating trauma]. [儿童眼眶异物；在未观察到穿透性外伤的情况下，考虑潜在损伤]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-03-31
Mustafa M A Al Saffar, Özlem Engin, Elske M Strabbing
{"title":"[Orbital foreign body in a child; think of underlying injury in not observed penetrating trauma].","authors":"Mustafa M A Al Saffar, Özlem Engin, Elske M Strabbing","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This case highlights the diagnostic and therapeutic challenges of managing pediatric penetrating orbital trauma, especially when the injury is not observed. An 8-year-old girl presented to the emergency department with a laceration of the right upper eyelid after a fall involving a pencil. The initial wound closure was followed by worsening symptoms, including orbital swelling, fever, and vomiting, leading to a suspicion of preseptal cellulitis. Despite intravenous antibiotics and surgical exploration, the condition deteriorated, prompting further investigation. A CT-scan revealed a metallic foreign body, confirmed during subsequent surgery as the back end of a pencil. The object was successfully removed, and the patient's symptoms gradually improved with additional antibiotic therapy. This case underscores the importance of vigilance in pediatric trauma cases with minimal external injury and the critical role of early imaging to identify hidden foreign bodies. Multidisciplinary collaboration and thorough follow-up are essential to ensure optimal outcomes and prevent complications.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795787","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
[Acute appendicitis - to cut or not to cut?] 急性阑尾炎——切还是不切？］
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-03-27
Jochem C G Scheijmans, Hiske Huisman, Wouter J Bom, Marja A Boermeester
{"title":"[Acute appendicitis - to cut or not to cut?]","authors":"Jochem C G Scheijmans, Hiske Huisman, Wouter J Bom, Marja A Boermeester","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Acute appendicitis has traditionally been seen as a progressive disease that necessitates surgery to prevent complications like perforation. However, recent studies emphasize the importance of distinguishing between complicated and uncomplicated appendicitis, rather than treating all cases the same. This evolving understanding has led to a paradigm shift in how uncomplicated appendicitis is diagnosed and treated, with options like antibiotic therapy being considered alternatives to immediate surgery. This shift challenges the long-held belief that surgery is always required, and instead encourages more personalized treatment approaches and shared decision-making between clinicians and patients.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720214","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
[Trauma of the hallux in an 11-year-old boy]. [一个11岁男孩的拇创伤]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-03-26
Nova D van den Bogerd, Samuel A J Fidder, Simon P Knops
{"title":"[Trauma of the hallux in an 11-year-old boy].","authors":"Nova D van den Bogerd, Samuel A J Fidder, Simon P Knops","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>An 11-year-old boy presented with an injury of the left foot. Initial X-rays indicated a Salter-Harris type 4 fracture of the proximal phalanx of the hallux, prompting consideration of surgery. However, further evaluation at the indications conference to discuss the scheduled surgical cases and a subsequent MRI revealed a physiological epiphyseal cleft leading to conservative treatment and the avoidance of surgery.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"168 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720431","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
[Prehospital care at the Rotterdam Marathon: This reduces the pressure on the acute care chain]. [鹿特丹马拉松的院前护理：这减少了急性护理链的压力]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-03-25
Nathalie Dollee, Thomas H Avedissian, Ankie Bultstra, Steven R Hofdom, Hans Arkesteijn, Kim Pannekoek, Amber E Hoek, Jelmer Alsma
{"title":"[Prehospital care at the Rotterdam Marathon: This reduces the pressure on the acute care chain].","authors":"Nathalie Dollee, Thomas H Avedissian, Ankie Bultstra, Steven R Hofdom, Hans Arkesteijn, Kim Pannekoek, Amber E Hoek, Jelmer Alsma","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To illustrate prehospital care during the Rotterdam Marathon and demonstrate its impact on the acute care chain.</p><p><strong>Design: </strong>Retrospective study of the impact of prehospital care during the Rotterdam Marathon from 2019 to 2024.</p><p><strong>Method: </strong>Data on the use of medical care and ambulances, as well as the diagnoses of the victims, were collected from the involved parties. Descriptive statistics were used for data analysis.</p><p><strong>Results: </strong>During the last five editions, an average of 219 victims were treated per year at medical posts, of which an average of 84 per year had injuries that would have resulted in an ambulance, emergency department or general practitioner visit without medical posts. There was sufficient emergency department capacity for urgent care.</p><p><strong>Conclusion: </strong>The multidisciplinary approach to prehospital care at the Rotterdam Marathon contributes to providing the right care in the right place and avoids unnecessary pressure on the regular acute care chain.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720351","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
[Jaundice in newborns]. [新生儿黄疸]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-03-25
Lidewij T Warris, C A Dogger, Jan B F Hulscher, Jessica M Pruijsen-Nienhuis, Henkjan J Verkade, Patrick F van Rheenen
{"title":"[Jaundice in newborns].","authors":"Lidewij T Warris, C A Dogger, Jan B F Hulscher, Jessica M Pruijsen-Nienhuis, Henkjan J Verkade, Patrick F van Rheenen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Jaundice is common in newborns. The decision to initiate diagnostic evaluation for the cause depends on the infant's age and stool color. The aim of this article is to discuss the underlying causes and how physicians should act when confronted with a jaundiced baby. Care for a jaundiced baby involves professionals from community-based to tertiary care. Good collaboration agreements are very important.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720349","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
[Help with nibs and mabs: targeted cancer therapies for non-oncologists]. [nibs和mabs的帮助：针对非肿瘤学家的靶向癌症治疗]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-03-24
Matthijs Plas, K Esther Broekman, Thijs H Oude Munnink, Mathilde Jalving
{"title":"[Help with nibs and mabs: targeted cancer therapies for non-oncologists].","authors":"Matthijs Plas, K Esther Broekman, Thijs H Oude Munnink, Mathilde Jalving","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Targeted therapies, including monoclonal antibodies and small molecules, are increasingly important components of oncological treatments. Targeted therapies are designed to tackle cancer cell pathogenesis at specific points essential to tumour survival and growth. These drugs can result in both on- and off-target side effects which are frequently clinically relevant. These side-effects are different from the classic and well-known chemotherapy side effects. As the number of cancer patients is growing worldwide and oncological treatment regimens become more complex, the demand for oncology expertise increases. All health care professionals that work with patients with cancer require basic knowledge of targeted therapies. Therefore, the goal of this article is to educate non-oncologists on new targeted cancer therapies, their mode of action and potential side-effects.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720307","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 'diabetes crisis': a historical reflection on the nature of the problem]. 【“糖尿病危机”：对问题本质的历史反思】。
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-03-20
Timo C Bolt
{"title":"[The 'diabetes crisis': a historical reflection on the nature of the problem].","authors":"Timo C Bolt","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Prompted by new epidemiological data on 'prediabetes', the current debate on the 'diabetes crisis' focuses on the scale of the problem. Less attention has been paid to the nature of the problem and the precise meaning of the aforementioned epidemiological data. In this regard, the history of prediabetes provides two valuable insights. First, a 'taxonomic expansion' has occurred, with the categories 'prediabetes' and 'diabetes' penetrating ever deeper into the domain of the asymptomatic. In addition, the 'convergence' of disease and risk has created confusion between two different ways of modelling. The term 'prediabetes' originally denoted a preliminary stage in the diabetic disease process, but now mainly indicates increased cardiovascular risk. On the basis of these two historical developments, important questions can be raised about the nature of the current 'diabetes crisis' and the aims of the Diabetes Fund's current campaign.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720354","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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