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[Paraneoplastic syndromes: the importance of early recognition and treatment]. 副肿瘤综合征：早期识别和治疗的重要性。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-05-19
Emma J van Dijk, Lieneke F M Ariens, Rutger Heinen, Britt B M Suelmann
{"title":"[Paraneoplastic syndromes: the importance of early recognition and treatment].","authors":"Emma J van Dijk, Lieneke F M Ariens, Rutger Heinen, Britt B M Suelmann","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Paraneoplastic syndromes are complexes of symptoms that can arise as a result of an immune response to an underlying malignancy. Various types of paraneoplastic syndromes exist: endocrine, metabolic, dermatological, rheumatological, hematological, and neurological. These syndromes occur more frequently than we might think, but their incidence varies greatly depending on the syndrome and the type of cancer. They can be difficult to recognize due to the wide variety of symptom complexes, and are frequently the first manifestation of a malignancy. Paraneoplastic syndromes can arise from humoral factors or autoimmunity, with immune-mediated paraneoplastic syndromes often not responding adequately to treatment of the underlying malignancy. Early recognition of a paraneoplastic syndrome is crucial both for diagnosing a malignancy at an earlier stage and for preserving the patient's quality of life.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148144069","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
[Navigating a Minefield: experiences and needs of young adults in Dutch transgender healthcare]. [穿越雷区：荷兰跨性别医疗保健中年轻人的经验和需求]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-05-14
Lise Woensdregt, Mi Jung van der Velde, Naomi S van Stapele
{"title":"[Navigating a Minefield: experiences and needs of young adults in Dutch transgender healthcare].","authors":"Lise Woensdregt, Mi Jung van der Velde, Naomi S van Stapele","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Transgender young adults in the Netherlands often experience healthcare as fragmented, inaccessible, and poorly matched to their medical and psychosocial needs. Many healthcare professionals report uncertainty due to limited experience with gender diversity. How do transgender young adults perceive current transgender healthcare, and what improvements do they consider necessary?</p><p><strong>Method: </strong>Using a Community-Led Research and Action (CLRA) approach, five transgender young adults conducted peer interviews and co-analyzed findings, supported by researchers in the social sciences. In total, 20 transgender young adults participated.</p><p><strong>Results: </strong>Participants described the healthcare system as a 'minefield', calling for improved medical knowledge on transgender issues, continuity of care, integration of lived experience, active involvement in healthcare policy and psychological support.</p><p><strong>Conclusion: </strong>Transgender young adults need accessible, relational, and knowledgeable care. For general practitioners and specialists, this implies investing in training, collaborating with lived-experience experts, and creating inclusive care environments where young adults feel safe and heard.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147974138","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
[Atoll sign: A CT finding with clinical impact]. [环礁征：具有临床影响的CT表现]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-05-13
Marie Verstraeten, Dieter Stevens
{"title":"[Atoll sign: A CT finding with clinical impact].","authors":"Marie Verstraeten, Dieter Stevens","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 48-year-old woman with metastatic cervical cancer treated with pembrolizumab and bevacizumab developed drug-induced organizing pneumonia characterized by the atoll sign on chest CT: rounded ground-glass opacities with a peripheral consolidation ring. Discontinuation of therapy led to complete radiological resolution and significant improvement in DLCO.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147974163","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 impact of obesity on natriuretic peptide cut-off values for the diagnosis of heart failure]. 肥胖对利钠肽临界值诊断心力衰竭的影响。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-05-13
Karim Taha, M Louis Handoko
{"title":"[The impact of obesity on natriuretic peptide cut-off values for the diagnosis of heart failure].","authors":"Karim Taha, M Louis Handoko","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Measurement of natriuretic peptides (BNP and NT-proBNP) has an important role in diagnosing heart failure. However, in patients with obesity, circulating levels of these peptides are consistently lower, yet current diagnostic cut-off values do not account for this. This article discusses the implications of obesity on natriuretic peptide interpretation, particularly in heart failure with preserved ejection fraction (HFpEF). Recent data show that the conventional rule-out threshold (<125 ng/L) lacks sensitivity in obese patients, potentially missing up to one-third of HFpEF cases. Lowering the cut-off in patients with obesity markedly improves diagnostic accuracy, while adjusted rule-in thresholds enhance specificity. These findings highlight the need for individualized interpretation of natriuretic peptide levels, incorporating body weight to avoid underdiagnosis of HFpEF in patients with obesity.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147974175","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
[Dermatology in skin of color]. [有色皮肤的皮肤病学]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-05-12
Dominique C de Vries, Dorina Kahedy, Alana E G Helberg-Proctor, Jim E Zeegelaar
{"title":"[Dermatology in skin of color].","authors":"Dominique C de Vries, Dorina Kahedy, Alana E G Helberg-Proctor, Jim E Zeegelaar","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Dermatological conditions on dark skin are often diagnosed late or incorrectly partly due to their limited representation in medical education and research. This contributes to poorer treatment outcomes, increased healthcare costs, and substantial health disparities. Recognizing clinical differences between lighter and darker skin types is therefore essential. In addition, cultural competence contributes to trust and treatment adherence; knowledge of patients' backgrounds, skincare practices, and hair-care routines supports appropriate care.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147840460","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 care of patients after hazardous materials incidents]. 【危险品事故后患者的护理】。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-05-11
Ronald de Groot, Tycho J Olgers, Jeroen Meintjens, Marike J I Liedenbaum, Antoinette J H P van Riel, Marc Ruijten
{"title":"[The care of patients after hazardous materials incidents].","authors":"Ronald de Groot, Tycho J Olgers, Jeroen Meintjens, Marike J I Liedenbaum, Antoinette J H P van Riel, Marc Ruijten","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>When treating patients involved in hazardous materials (HazMat) incidents, rapid action is essential to stop exposure and provide appropriate care. Uncertainty about secondary exposure, however, may lead to unnecessary protective measures and delayed treatment. A clear distinction between exposure and contamination is crucial. Decontamination is only indicated when hazardous substances remain present on the patient's skin, hair, or clothing; it is not required after isolated ingestion or inhalation without skin involvement. Available evidence shows that the risk from secondary exposure of healthcare providers is very low. In most situations outside the source area, standard personal protective equipment (PPE: gloves and apron, supplemented with FFP2 mask and eye protection when particulate matter is involved) provides sufficient protection to safely perform triage and lifesaving interventions. More extensive PPE may be considered during prolonged decontamination procedures or large-scale incidents. Early communication and consultation with hazardous materials advisors support a proportional and safe approach to patient care.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147840499","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
[Smart use of AI in healthcare: the growing role of AI literacy]. [人工智能在医疗保健中的智能应用：人工智能素养的日益重要作用]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-04-30
Sara Ben Hmido, Freek Daams, Denise E Hilling, Diederik A M P J Gommers, Michel E van Genderen, M C Corrette Ploem
{"title":"[Smart use of AI in healthcare: the growing role of AI literacy].","authors":"Sara Ben Hmido, Freek Daams, Denise E Hilling, Diederik A M P J Gommers, Michel E van Genderen, M C Corrette Ploem","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Artificial intelligence (AI) offers opportunities for more efficient care, improved communication, and support in diagnostics and clinical decision-making. The transition to safe application in practice, however, requires AI literacy: the ability to understand the functioning, limitations, and risks of systems and to use them critically. The European Regulation on artificial intelligence (AI Act) obliges providers, deployers, and users to ensure an appropriate level of AI literacy. This article outlines the core aspects of AI literacy, with specific attention to predictive models and generative AI, including their pitfalls such as bias, confounding, hallucinations, and automation bias. The distribution of responsibilities is also addressed: providers are expected to ensure transparency and validation, deployers to establish governance and training, and healthcare professionals to apply contextual interpretation. Education and assessment of both basic knowledge and application are essential, from initial training to specialist practice. Only through early and structural investment in AI literacy can human oversight be safeguarded and patient safety maintained.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147776878","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 blind spot in oncological care; disease scenarios as a foundation for careful decision-making]. 肿瘤护理的盲区；疾病情景作为谨慎决策的基础]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-04-29
Evelien J M Kuip, Eric C T Geijteman, Hans M Westgeest
{"title":"[The blind spot in oncological care; disease scenarios as a foundation for careful decision-making].","authors":"Evelien J M Kuip, Eric C T Geijteman, Hans M Westgeest","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article explores what highquality oncological care requires when cure is no longer possible. As the focus shifts toward quality of life, with or without active antitumor therapy, patients typically receive structured information when treatment is initiated, but far less explicit information when treatment is withheld. The absence of systematic discussion about symptom burden, likely disease trajectories, and prognostic uncertainty can negatively affect physical, psychosocial, and existential wellbeing. Clear, scenariobased information is essential not only for patients and their families but also for general practitioners, who often assume primary responsibility in later disease stages. Given the increasing complexity of treatment options and disease courses, oncologists should take the lead in outlining realistic prognostic scenarios. Providing equal attention to the expected course of illness and to treatmentrelated information helps ensure shared decisionmaking and equips general practitioners to deliver informed, careful, and continuous care.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147776978","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
[Looking at care differently; a plea for art in medical education]. [以不同的方式看待护理；医学教育中对艺术的呼吁]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-04-28
Laura Alexandra van der Woude, Marco Antonio de CarvalhoFilho, Suzanne Festen
{"title":"[Looking at care differently; a plea for art in medical education].","authors":"Laura Alexandra van der Woude, Marco Antonio de CarvalhoFilho, Suzanne Festen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Personcentered care is essential for a futureproof healthcare system, yet its implementation lags behind due to a predominantly diseasecentered perspective. Traditional educational approaches appear insufficient to shift this mindset. Perspective change rarely results from information transfer alone; it arises through personal experience. Art brings this experiential dimension into medical education and fosters a different way of seeing care. It helps healthcare professionals deal with complexity, uncertainty, and recognize their own assumptions. In the Netherlands, several artbased initiatives exist within medical training, including Medical Education Empowered by Theater for shared decisionmaking (MEET SDM). MEET SDM is an experiential training designed to promote perspective change for learning shared decisionmaking. Through reflexive dialogue, theater- and improvisational exercises, participants experience that shared decisionmaking requires genuine attention to another's perspective, connection, and (non)verbal presence. Participants reported concrete personcentered behavioral changes in clinical encounters, positively influencing the doctor-patient relationship. Artbased education contributes to overcoming the disease-centered perspective and supports a different way of viewing oneself, one's professional role, and the patient.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147776872","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
[Treatment of umbilical granuloma with table salt]. 【食盐治疗脐肉芽肿】。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-04-28
Eva P Timmermans, Tjalling W de Vries, Maaike Kok
{"title":"[Treatment of umbilical granuloma with table salt].","authors":"Eva P Timmermans, Tjalling W de Vries, Maaike Kok","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Umbilical granulomas are common in newborns. In The Netherlands, they are commonly treated with silver nitrate. Elsewhere, table salt (sodium chloride) is also used for this purpose. We investigated whether treatment with table salt is effective and feasible for parents.</p><p><strong>Methods: </strong>For this study, we approached parents of newborns with an umbilical granuloma. We demonstrated the treatment once and asked the parents to apply table salt to the granuloma twice daily for three days. We assessed the results 14 days after the start of the treatment. We asked parents about the results, side effects, their satisfaction, and whether they found the treatment feasible.</p><p><strong>Results: </strong>Twenty-eight children participated in this study, and after fourteen days, the granuloma had disappeared in 25 (89%). In nine children (32%), the surrounding skin showed transient reddening. According to 24 parents (86%), the treatment was feasible, and 23 of them (82%) were satisfied with the results.</p><p><strong>Discussion: </strong>Parental application of table salt is an appealing alternative to silver nitrate in the treatment of umbilical granuloma.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777003","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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