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[Promotion for medical devices; what is actually allowed?] [医疗器械推广；实际允许的是什么？］
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-04-23
Jeroen F Schouten, Loes M Schepers, John A Lisman, C Kees Kramers
{"title":"[Promotion for medical devices; what is actually allowed?]","authors":"Jeroen F Schouten, Loes M Schepers, John A Lisman, C Kees Kramers","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Medical devices are increasingly promoted to healthcare professionals for both onlabel and offlabel uses, often on the basis of limited or selectively presented evidence. In contrast to the strictly regulated advertising rules for medicinal products, oversight of promotional claims for medical devices appears less consistent. The article illustrates this issue with examples. CytoSorb is a hemoadsorption device certified for cytokine removal and several additional indications. It is actively promoted for treating acute intoxications despite lacking clinical studies and showing pharmacokinetic implausibility. Catheterbased interventions for venous thromboembolism (VTE) and vacuum therapy, although onlabel, are increasingly encouraged despite limited evidence and contested guideline recommendations. These examples highlight the need for a critical approach among healthcare professionals when evaluating new technologies.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147776886","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
[Diagnosis and management of pulmonary sarcoidosis]. 肺结节病的诊断与治疗
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-04-22
Rémy L M Mostard, Vivienne Kahlmann, Viresh A Jagesar, Sophie C van der Mark, Rob E T Nocker, Marlies S Wijsenbeek
{"title":"[Diagnosis and management of pulmonary sarcoidosis].","authors":"Rémy L M Mostard, Vivienne Kahlmann, Viresh A Jagesar, Sophie C van der Mark, Rob E T Nocker, Marlies S Wijsenbeek","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The clinical presentation and both the nature and severity of organ involvement are highly heterogeneous and are influenced by ethnic, genetic, and geographic factors. Establishing the diagnosis can be challenging due to the wide spectrum of clinical manifestations. Careful assessment of the indication for pharmacological treatment, as well as the preferred agent, is of paramount importance in every patient to optimize management and to minimize the risk of potentially serious adverse effects. Supportive measures and non-pharmacological treatment options may relieve symptoms and improve quality of life. In this article, we present a patient in whom the diagnosis of pulmonary sarcoidosis was established and for whom an indication for immunosuppressive therapy was present. Using this case history, we illustrate the diagnostic process and current therapeutic developments in pulmonary sarcoidosis.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147776913","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 remarkable swelling in the genital region of a newborn girl]. [新生女孩生殖器区域的显著肿胀]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-04-22
Charlotte S van den Aardwegh, Willemieke S F J Tummers, C E J Sloots
{"title":"[A remarkable swelling in the genital region of a newborn girl].","authors":"Charlotte S van den Aardwegh, Willemieke S F J Tummers, C E J Sloots","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Prenatal ultrasound showed an abdominal mass in a female foetus. During clinical examination of the neonate after birth, a bulging mass was visible at the introitus. The urethra and anus were patent, confirming the diagnosis of an imperforate hymen. Surgery was performed to release the resulting mucocolpos.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147776939","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
[Surgical treatment of diverticulitis: the current state of affairs]. 【憩室炎的外科治疗：现状】。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-04-20
Nils P van der Beeke, Henderik L van Westreenen, Willem A Bemelman, Esther C J Consten
{"title":"[Surgical treatment of diverticulitis: the current state of affairs].","authors":"Nils P van der Beeke, Henderik L van Westreenen, Willem A Bemelman, Esther C J Consten","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Diverticulitis is a common benign gastrointestinal condition with a variable clinical course, ranging from mild, self-limiting episodes to severe presentations requiring surgery. This article presents two contrasting cases of diverticulitis requiring surgery: one of recurrent, uncomplicated diverticulitis, and another of acute diverticulitis with a covered perforation progressing to purulent peritonitis. These cases illustrate the broad spectrum of disease severity and the evolving, individualized approach to management. Elective sigmoid resection may improve quality of life in patients with colonic stenosis, diverticular fistula, or with recurrent and chronic symptoms, while acute complications such as perforation and peritonitis necessitate direct surgical intervention. Current evidence supports minimally invasive techniques and primary anastomosis in the majority of patients, even in emergency settings. The article underscores the importance of shared decision-making, appropriate diagnostic work-up, and patient tailored treatment strategies for optimal outcomes for patients with diverticulitis.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147776880","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
[Boosting oxytocin in postpartum depression]. [提高产后抑郁症的催产素]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-04-16
Madelon M E Riem, Lisa Loheide-Niesmann, Roseriet Beijers, Indira Tendolkar, Peter C Mulders
{"title":"[Boosting oxytocin in postpartum depression].","authors":"Madelon M E Riem, Lisa Loheide-Niesmann, Roseriet Beijers, Indira Tendolkar, Peter C Mulders","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>We examined whether intranasal oxytocin affects maternal caregiving, mood, and stress physiology in mothers with postpartum depression (PPD).</p><p><strong>Design: </strong>Double-blind, randomized, within-subject study.</p><p><strong>Method: </strong>45 mothers of 3-to-9-month-old infants with clinically relevant depressive symptoms, 35 of whom met criteria for major depressive disorder, received 24 IU intranasal oxytocin or placebo. Maternal sensitivity, expressed positive regard for the child, self-reported mood, and physiological stress responses (salivary cortisol, heart rate (variability)) were assessed during mother-infant interactions.</p><p><strong>Results: </strong>Oxytocin increased maternal positive regard for the child and self-reported positive affect but had no effect on sensitivity, negative mood, or stress physiology.</p><p><strong>Conclusion: </strong>Oxytocin enhances positive maternal emotions in PPD and may represent a neurobiological link between PPD and reduced positive caregiving. Stimulating endogenous oxytocin release, such as skin-to-skin contact, could help strengthen the mother-infant relationship in PPD. Future research should clarify oxytocin's therapeutic potential, taking into account administration context and PPD severity.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691208","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
[Deep vein thrombosis resulting in arterial occlusion]. [引起动脉闭塞的深静脉血栓]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-04-15
Ilja van Lingen, Stefanie Slot, Marije M G Krul, Linda de Nooij, Sjoerd H de Hoog
{"title":"[Deep vein thrombosis resulting in arterial occlusion].","authors":"Ilja van Lingen, Stefanie Slot, Marije M G Krul, Linda de Nooij, Sjoerd H de Hoog","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A patent foramen ovale (PFO) is present in approximately 25-30% of adults and is usually asymptomatic. However, under conditions of elevated right heart pressure, a PFO can enable right-to-left shunting, allowing venous thrombi to enter the arterial circulation: a mechanism known as paradoxical embolism. We present a case of a 51-year-old woman who developed dyspnea, abdominal pain and, a painful swollen leg. Imaging revealed a saddle pulmonary embolism, renal and splenic infarctions and occlusion of the right brachial artery. Echocardiography confirmed the presence of a PFO. Other common sites of paradoxical embolism include the brain, mesenteric circulation, and coronary arteries. In patients with venous thrombosis, clinicians should carefully assess for signs of concomitant arterial embolism: examine the abdomen, evaluate peripheral pulses in the limbs and perform a basic neurological examination. This case highlights the importance of thorough clinical evaluation to ensure timely recognition of this potentially serious condition.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691174","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
[Insomnia: cognitive behavioral therapy better than pills]. [失眠：认知行为疗法优于药物]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-04-14
Nynke L Rauwerda, Mette H Bakker
{"title":"[Insomnia: cognitive behavioral therapy better than pills].","authors":"Nynke L Rauwerda, Mette H Bakker","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Chronic insomnia is a common condition that significantly burdens patients and increases the risk of various comorbidities. Cognitive Behavioral Therapy for Insomnia (CBT-I) is the recommended first-line treatment and has shown strong, long-lasting effects with fewer side effects compared to medication. This article presents a representative case study of a woman with long-term insomnia,illustrating the core components and practical implementation of CBT-I, including the combination with medication tapering. CBT-I targets the maintaining factors of insomnia through behavioral techniques (e.g. sleep restriction) and cognitive interventions, and restoring daytime balance. Up to 80% of patients experience clinically relevant improvements, even with comorbid conditions. In contrast, sleep medications like temazepam or zolpidem should be used cautiously, for no longer than 2-4 weeks. CBT-I leads to more sustainable outcomes and supports patient autonomy. Wider implementation in clinical practice is hindered by limited awareness, access, and reimbursement, despite strong evidence for its effectiveness.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691211","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
[Drug repurposing requires a strategic approach]. [药物再利用需要一种战略方法]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-04-09
Michelle W J Heijman, Calin Popa, Bart J F van den Bemt
{"title":"[Drug repurposing requires a strategic approach].","authors":"Michelle W J Heijman, Calin Popa, Bart J F van den Bemt","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Drug repurposing is often presented as a cost-effective strategy to accelerate the development of new therapies. The underlying rationale is that the safety, pharmacokinetics and pharmacodynamics, and mechanism of action of these drugs are already known, as preclinical research phases have been completed and clinical experience has already been gained. Although repurposing therefore appears to be an attractive approach for many diseases, initiatives often encounter various practical challenges. To address these challenges, a clear strategy should be developed in advance, taking into account (1) the thoughtful selection of a candidate drug, (2) efficient use of (existing) data, and (3) successful implementation of the drug in clinical practice, with early involvement of relevant stakeholders.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627855","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 toddler with red-yellow facial papules]. [脸上有红黄色丘疹的幼儿]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-04-08
Elodie F Holwerda, Eefje A Hamminga
{"title":"[A toddler with red-yellow facial papules].","authors":"Elodie F Holwerda, Eefje A Hamminga","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A three-year-old boy presented with asymptomatic facial papules. Biopsy revealed dermal histiocyte proliferation. Based on clinical and histological findings, benign cephalic histiocytosis - a rare, self-limiting condition of infancy - was diagnosed. Recognition is key due to overlap with more serious histiocytic disorders such as Langerhans cell histiocytosis.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627672","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
[Care for people with a migration background]. [关心有移民背景的人]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2026-04-07
Maria E T C van den Muijsenbergh, Charles C Obihara, Bahar Golchehr
{"title":"[Care for people with a migration background].","authors":"Maria E T C van den Muijsenbergh, Charles C Obihara, Bahar Golchehr","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In comparison with others, migrants more often suffer from chronic illnesses and conditions that are less familiar to physicians trained in the Netherlands. At the same time access to care can be hampered by language barriers and care that is insufficiently tailored to their needs. This article offers practical information for physicians on the specific aspects of health and care of people with a migration background. With this knowledge, the article hopes to contribute to effective person centred care for people with a migration background.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"170 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627893","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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