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[Abstinence or controlled alcohol consumption?] 戒酒还是控制饮酒？］
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-02-13
Michiel Gravesteijn, Willem Baijens, Robert Meijburg, Elianne van Hoogdalem
{"title":"[Abstinence or controlled alcohol consumption?]","authors":"Michiel Gravesteijn, Willem Baijens, Robert Meijburg, Elianne van Hoogdalem","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Disorders in alcohol consumption are among the most common, having the highest impact on morbidity and mortality, in mental health care. Treatment strategies differ greatly between institutions and the aim for controlled alcohol consumption remains controversial. The risk of (somatic) complications of alcohol abuse increase with a higher quantity of consumption, however there is no clear threshold regarding the development of certain health issues due to numerous factors determining individual susceptibility. Problematic alcohol abuse is treated either by aiming for complete abstinence, abstinence for the duration of therapy or controlled alcohol consumption. Considering a medical perspective aiming for abstinence in alcohol consumption is preferred, which however results in large amounts of untreated patients and limited effectivity. In our opinion, this advocates for a role of controlled alcohol consumption as 'harm reduction', focusing on the perspective of personal and communal recovery.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399546","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
[An infant with a neck mass]. [颈部有肿块的婴儿]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-02-12
Jordy Bolks, Robert J J van Es
{"title":"[An infant with a neck mass].","authors":"Jordy Bolks, Robert J J van Es","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This case involves a boy with progressive swelling of the neck diagnosed as Cystic Hygroma by ultrasound and MRI. After an initially wait-and-see approach because of his age and lack of symptoms, increased swelling led to surgical excision, which is preferred over sclerotherapy. After 2 months there was minimal scarring and no recurrence.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"168 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255853","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
[Gender differences in career paths in medical academia: a nationwide study in the Netherlands]. [医学学术界职业道路中的性别差异：荷兰的一项全国性研究]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-02-11
Silvan Licher, Daphne L van Helden, Margot M Weggemans, Coen B J van Deursen, Bas Holverda, Michiel van der Vaart, Miranda Wijdenes, Meike W Vernooij, Frank J Wolters
{"title":"[Gender differences in career paths in medical academia: a nationwide study in the Netherlands].","authors":"Silvan Licher, Daphne L van Helden, Margot M Weggemans, Coen B J van Deursen, Bas Holverda, Michiel van der Vaart, Miranda Wijdenes, Meike W Vernooij, Frank J Wolters","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To determine gender differences in career progression of physicians.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Method: </strong>We examined career progression until 2023 of 715 physicians who received their PhD in the Netherlands in 2007/2008. We also pooled data from 7 national grant programs from 2005 up until Jan 1, 2023.</p><p><strong>Results: </strong>Fifteen years after their PhD defence, 43% of physicians worked in academia, similar for men and women. Men published more than women (9[3-27] vs. 6[2-15] publications; p=0.001), especially in academia. Women were less likely than men to be appointed full professor (10/330 vs. 27/385; odds ratio[95% CI]: 0.41[0.20-0.87]), which was mediated for 55% by their number of scientific publications. Women increasingly applied for research grants over time, with an equal number of women and men receiving 'early career' grants since 2015. More men applied for 'established investigator' grants, without any gender differences in award rates.</p><p><strong>Conclusion: </strong>Career perspectives in the early phase after obtaining a PhD, including grant allocation, are similar for male and female physicians. Differences in their later career phase were partly related to a higher number of scientific publications by men, compared to women.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399516","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
[Automatic formula dispensers, relief or risk?] 自动配方分配器，缓解还是风险？］
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-02-04
Ilse Bel, Justus M Maier, Sanne de Kreij, Richard A van Lingen
{"title":"[Automatic formula dispensers, relief or risk?]","authors":"Ilse Bel, Justus M Maier, Sanne de Kreij, Richard A van Lingen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The usage of automatic formula dispensers comes with certain risks which are commonly unknown to parents and caregivers. In this article we describe two cases in which incorrect usage of these dispensers resulted in health issues. In one case the usage of a formula dispenser resulted in failure to thrive and in the other case it resulted in prolonged abdominal pain. These two cases emphasize the importance of extensive history taking regarding nutrition in cases with failure to thrive or nutritional difficulties. Caregivers should be aware of the potential risks associated with automatic formula dispensers. Furthermore, it is of importance to provide comprehensive guidance to parents regarding the correct utilization of these dispensers.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255845","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
[Dealing with deep uncertainty during a pandemic; make policies adaptive]. [应对大流行期间的高度不确定性；使政策具有适应性]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-01-30
Marcel G M Olde Rikkert, Etiënne Rouwette, Hubert Korzilius, Tom Oreel, Rick Quax, Vincent Marchau, Heiman Wertheim
{"title":"[Dealing with deep uncertainty during a pandemic; make policies adaptive].","authors":"Marcel G M Olde Rikkert, Etiënne Rouwette, Hubert Korzilius, Tom Oreel, Rick Quax, Vincent Marchau, Heiman Wertheim","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article is a reflection on the covid-19 pandemic and the policy on medical and non-medical e.g. (lock down) measures, and on how we can anticipate earlier on for example effects on education and wellbeing of young people. We show that insights from complexity science are relevant for pandemic policy making and advocate use of resilience indicators, alternative computational models and deep uncertainty modeling. Time series of sick leave can act as resilience indicator in health care and showed large difference between acute care, long term care and mental health care in Dutch covid-19 pandemic. Instead of epidemiology based predict and act models, which mostly turn out to be incorrect, we developed alternative multiscale modelsto simulate interdomain effects. In sum, future pandemics policymaking can profit from adaptive decision making under deep uncertainty.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008639","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
[Residency attrition in orthopaedic surgery; an explanatory model based on qualitative research]. 骨科住院医师磨耗；一个基于定性研究的解释模型[j]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-01-29
Jos J A M van Raaij, Jan Pols, Yvonne Ten Hoeve, A D C Jaarsma, Astrid J de Vries
{"title":"[Residency attrition in orthopaedic surgery; an explanatory model based on qualitative research].","authors":"Jos J A M van Raaij, Jan Pols, Yvonne Ten Hoeve, A D C Jaarsma, Astrid J de Vries","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Many factors can lead to residency attrition. The underlying process however and how these factors interact remains unclear. Understanding this process can provide background to put the available evidence into perspective. The aim of the study was to develop an explaining model that describes voluntary residency attrition.</p><p><strong>Design: </strong>Development of an explanatory model based on qualitative research METHOD: Semi-structured interviews with orthopaedic surgery residents in the Netherlands who dropped out of training, were analysed using the constructivist grounded theory approach.</p><p><strong>Results: </strong>17 interviews were analysed. Reasons for attrition were different for each individual and often a result of a cumulative effect of negative experiences. Individual expectations and needs determine residents' experience with the content of the profession, the professional culture and the learning climate. Personal circumstances and personal characteristics influence expectations and needs. Specific aspects of the residency programme contributing to attrition were type of patient care, required skills, work-life balance and interpersonal interaction (between residents among themselves and between residents and supervisors).</p><p><strong>Conclusion: </strong>This study provides an explaining model of residency attrition that incorporates existing theories and fits well with the results of previous studies.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008646","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
[Neurological side-effects associated with immune checkpoint inhibitors]. [与免疫检查点抑制剂相关的神经系统副作用]。
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-01-29
Wouter W van Willigen, Dieuwke A Schreurs, Frank M Speetjens, Ellen Kapiteijn, Umesh A Badrising
{"title":"[Neurological side-effects associated with immune checkpoint inhibitors].","authors":"Wouter W van Willigen, Dieuwke A Schreurs, Frank M Speetjens, Ellen Kapiteijn, Umesh A Badrising","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The use of checkpoint inhibitors has shown significant clinical benefit in various cancer types but also carries a risk of immune-related adverse events (irAEs). As the use of checkpoint inhibitors continues to rise, so does the incidence of irAEs. Among these, neurological adverse events (neuro-irAEs) are particularly challenging to detect since they can manifest with a wide range of symptoms, often mimicking disease progression. In addition, neuro-irAEs may follow a severe clinical course, potentially leading to life-threatening consequences if not recognized promptly. We present three cases illustrating the variety in symptoms and signs related to neuro-irAEs including muscle weakness, sensory disturbances, intermittent seizures and double vision. In each scenario, the probable diagnosis of a neuro-irAE posed a significant challenge, necessitating the exclusion of alternative causes. This emphasizes the need for awareness among healthcare professionals regarding neuro-irAEs in the era of expanding checkpoint inhibitor use.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008645","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
['More research is needed' is a meaningless conclusion]. （‘需要更多的研究’是一个毫无意义的结论）。
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-01-28
Yvo M Smulders, Jonne J Sikkens
{"title":"['More research is needed' is a meaningless conclusion].","authors":"Yvo M Smulders, Jonne J Sikkens","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This sentence often concludes medical research articles. We argue that 'more research is needed' is an empty phrase. There is always room for synthesis of previously existing and currently added knowledge, allowing for a conclusion on what we now know. Surely, current knowledge is rarely definitive. Sometimes it is, however, in which case valuable resources are better spent elsewhere, rather than in more research on the topic of interest.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008643","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
[Shaking hands or not after the COVID pandemic?] [COVID大流行后握手与否？］
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-01-27
Richard H C Zegers, Rosa van Mansfeld, Rudi D'Hooge, Danny H de Vries
{"title":"[Shaking hands or not after the COVID pandemic?]","authors":"Richard H C Zegers, Rosa van Mansfeld, Rudi D'Hooge, Danny H de Vries","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The tradition of physicians to shake hands with patients is controversial due to the risk of transmitting germs and because of cultural sensitivity. Nevertheless, handshaking is a common way of greeting in Western culture, although some patients prefer not to shake hands for religious or cultural reasons. It is also known that a handshake can transmit pathogenic microorganisms. There are various alternative greetings possible - such as a nod or a bow - that do not carry the potential infection risk of physical contact and also respect patients who do not want to shake hands. There are also many other ways besides handshaking to show respect and engagement towards the patient. Therefore, it is time to seriously reconsider the practice of shaking hands with patients, especially during the season of viral respiratory infections and/or when there are many changing patient contacts, and use alternative greetings when possible and/or desirable.</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008647","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
[Should we all do mouth taping? The real story behind breathing through the nose.] 我们都应该用嘴录音吗？用鼻子呼吸背后的真实故事。
Nederlands tijdschrift voor geneeskunde Pub Date : 2025-01-23
Digna M A Kamalski
{"title":"[Should we all do mouth taping? The real story behind breathing through the nose.]","authors":"Digna M A Kamalski","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Breathing through the nose has many benefits compared to mouth breathing. There are ways to force breathing through the nose, for instance by mouth taping. It is, however, normal that nasal passage variates. This article describes the normal physiologic variations in nasal breathing. Mouth taping is not needed to change it!</p>","PeriodicalId":18903,"journal":{"name":"Nederlands tijdschrift voor geneeskunde","volume":"169 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255849","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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