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[Older patients with suspected malignancy]. [疑似恶性肿瘤的老年患者]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-01-14
Ewout B Smit, J Wessel Versteeg, Kathelijn S Versteeg
{"title":"[Older patients with suspected malignancy].","authors":"Ewout B Smit, J Wessel Versteeg, Kathelijn S Versteeg","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Some older patients with suspected malignancy are not automatically eligible for a standard care process due to frailty or limited treatment wishes. For this group we recommend a personalized approach in which frailty is identified and the patient's wishes are central. To achieve appropriate care, cooperation and timely consultation between primary care or elderly care with a geriatric and/or oncological specialist from secondary care is important. Together, a care plan can be realized, and agreements can be made as to who will have the management role.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983750","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
[Building trust together]. （共同建立信任）。
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-01-09
Arno van Dam, Bart Timmers
{"title":"[Building trust together].","authors":"Arno van Dam, Bart Timmers","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Since the corona pandemic, there has been more distrust towards the government and official institutions, more people are attracted to conspiracy theories and society has become more polarized. This increased distrust is also reflected in doctors' consulting rooms. It can be specifically aimed at medical interventions, the prescription of medication and the use of vaccinations, but also more broadly at the doctor as a representative of the established order. This requires doctors to be able to build a good working relationship with a distrustful patient. A conversation technique that has proven effective in promoting collaborative relationships in the event of conflicting beliefs between doctor and patient is the LEAP method. This article provides directions on how doctors can talk and collaborate with distrustful patients.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971511","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 14-year-old boy with painful oral lesions]. [14岁男孩，口腔病变疼痛]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-01-08
Martijn P van Vliet, Frank J Smit
{"title":"[A 14-year-old boy with painful oral lesions].","authors":"Martijn P van Vliet, Frank J Smit","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This case concerns a boy presenting with oral pain and multiple mucocutaneous lesions such as mucositis, conjunctivitis, and a rash on the trunk, extremities, and genitalia. The presence of mild respiratory complaints raised suspicion of an extrapulmonary manifestation of <i>Mycoplasma pneumoniae</i>, known as <i>Mycoplasma pneumoniae</i>-induced Rash and Mucositis (MIRM). The patient underwent conservative treatment and was monitored to prevent chronic sequels such as ocular damage or sicca keratoconjunctivits.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971442","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
[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
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