Journals Nederlands Tijdschrift Voor Ge...

Nederlands Tijdschrift Voor Geneeskunde
Cathrien A Eggink, Marjolijn C Bartels, Wietze H Eizenga
The general physician as well as the medical specialist may be confronted with a patient with one or two red eyes. To be adequately equipped we answer a series of questions on diagnosis, treatment and referral of patients with red eyes after trauma, or with conjunctivitis, keratitis, scleritis, uveïtis, endophthalmitis or acute glaucoma. Refer to an ophthalmologist or not?
May 20, 2024: Nederlands Tijdschrift Voor Geneeskunde
Eline M Roordink, Anita W M Suijkerbuijk, Agata J Brouwer-Prusak, Martine Jansen-van der Vliet, Babette Everaars
OBJECTIVE: To gain insight into experiences of women and men who have experienced an unintended pregnancy, along with the perspectives of healthcare providers offering decision-making counseling/consultations concerning an unintended pregnancy or abortion. DESIGN: Semi-structured interviews and focus groups. METHODS: Twenty-five interviews were held with women and men whom experienced an unintended pregnancy, while nineteen healthcare providers participated in four focus groups (May-July 2021)...
May 16, 2024: Nederlands Tijdschrift Voor Geneeskunde
Uzaifa Sheikh, Tjeerd R de Jong, Joris M Franken, Wytske A Hofstra
A dropping foot is the consequence of a variety of debilitating conditions and is oftentimes treated conservatively by general practitioners and other specialists. Typically, it is caused by peroneal nerve palsy secondary to compression or a hernia nucleosipulpei at the level L4-L5. Identifying the underlying pathology requires a neurological work-up oftentimes including ultrasound and electromyographic investigation. When a peroneal nerve compression is found, decompression can be achieved operatively. Should the underlying cause of the dropping foot have been treated adequately without an effect on the foot itself, then a posterior tibial tendon transfer may be considered...
May 16, 2024: Nederlands Tijdschrift Voor Geneeskunde
Stefanie J G Veenhuis, Christel F M van der Donk, Ben A Semmekrot, Paul G Voorhoeve
BACKGROUND: Worldwide, disease in children due to exposure to rats is increasing, also in the Netherlands. Not only the generally known pathogen Leptospira should be considered, also S. moniliformis , Yersinia pestis , Lymphocytic choriomeningitis virus, Hantavirus, Francisella tularensis and Pasteurella multocida are also known rat-associated zoonosis. CASE DESCRIPTION: An 12-year-old boy visited the pediatrician with fever, headache and nausea, followed by generalized erythema and arthritis...
May 14, 2024: Nederlands Tijdschrift Voor Geneeskunde
Etienne J M Janssen, Melanie Burgers, Gerthe F Kerkhof, Merel Klaassens, Margje Sinnema, Joyce M Geelen
Due to its rare nature and subtle dysmorphisms, Prader-Willi syndrome can be challenging to recognize and diagnose in the neonatal period. Feeding difficulties and hypotonia ('floppy infant') are the most striking characteristics. Prader-Willi syndrome requires specific follow-up and treatment, emphasizing the importance of early recognition.We encountered an infant of three months old with severe hypotonia. The hypotonia ameliorated spontaneously over time, although feeding per nasogastric tube was necessary...
May 8, 2024: Nederlands Tijdschrift Voor Geneeskunde
Nandi Meijs, Brigit A De Jong, Bob W Van Oosten, Eva M M Strijbis
Multiple sclerosis is a chronic inflammatory disease of the central nervous system, caused by an autoimmune reaction. Treatment options have largely increased over the years. In this article, we present two clinical cases. Patient A has a classic relapsing remitting course of multiple sclerosis with satisfactory effect on second line therapy. Patient B had a stable disease course until a new relapse occurred after the initiation of TNF-alpha blocking therapy because of Crohn's disease. The co-occurrence of multiple auto-immune diseases creates challenges, but also opportunities in choosing the right treatment strategy...
May 6, 2024: Nederlands Tijdschrift Voor Geneeskunde
Antonia Felzen, Rob Rolink, Gerben J Bulthuis
This case concerns a 58-year-old man who had a progressively swollen knee over the course of 4 months. X-ray showed bursal swelling without skeletal abnormalities. Diagnostic puncture showed red/serous fluid and pathology of the extirpated bursa showed signs of chronic pre-patellar bursitis, most likely caused by a previous trauma.
May 1, 2024: Nederlands Tijdschrift Voor Geneeskunde
A C Hendriks, M C de Vries
Offering meaningful care to patients with an addiction is not always easy. This also holds true for general physicians. In this article we provide a legal and practical framework for general physicians on how to provide meaningful care for this group of patients. Various interventions are described. In case meaningful care does not seem to be an option, then the general physician has to draw his conclusions.
April 25, 2024: Nederlands Tijdschrift Voor Geneeskunde
J L I Burggraaf-van Delft, Hannah M la Roi-Teeuw, J de Wit, F A Klok, S C Cannegieter, G J Geersing
Pulmonary embolism (PE) is a common disease, which can present with a variety of symptoms. Optimal use of diagnostics is challenging given the tight and delicate balance between underdiagnosis and over-testing or overdiagnosis. Diagnostic delay occurs in a substantial part of patients, and seems more common in those with known cardiopulmonary disease or non-specific signs and symptoms. At the other end of the spectrum, the amount of diagnostic imaging increases. Increased use of diagnostic imaging in general leads to more harmful exposures and might result in overtreatment, as may be the case in subsegmental PE...
April 24, 2024: Nederlands Tijdschrift Voor Geneeskunde
Romy Takken, Sander Mol, Samara Guillen, Nicole A Volkers
BACKGROUND: Septic sacroiliitis is an uncommon disease which represents approximately 1-4% of all joint infections, therefore it is difficult to make the right diagnosis and to start early treatment. CASE REPORT: A 18 year old woman was admitted to the emergency room with a fever and pain in the left gluteal region. The patient was considered healthy and had no risk factors for septic arthritis. Edema and a small abscess was found in and around the left sacroiliac joint on pelvic MRI...
April 22, 2024: Nederlands Tijdschrift Voor Geneeskunde
Michael A Harkhoe, Tim M Offringa, Robert R J M Vermeiren, Laura A Nooteboom
OBJECTIVE: To describe the impact of social media on youths with severe anorexia nervosa. DESIGN: Qualitative study. METHOD: Through semi-structured interviews with eleven youths diagnosed with anorexia nervosa, opinions and experiences surrounding the impact of social media on anorexia nervosa were collected, coded and analyzed using thematic analysis. RESULTS: Social media are often used to compensate for social isolation or misunderstandings about anorexia nervosa from friends and family...
April 18, 2024: Nederlands Tijdschrift Voor Geneeskunde
Robert Jan Derksen, Olivier A J van der Meijden, Louise E Huygen, Femke Boon, Astrid C J Balemans, David N Baden
Shoulder dislocations remain the most frequent of joint dislocations, with anterior displacement of the humeral head being the direction of dislocation seen most often (97%). Recently, the Dutch clinical guideline on shoulder dislocations has been revised on the basis of predetermined bottlenecks in clinical practice. In this paper, the guideline is translated to clinical practice by means of two fictional cases, in which the novel recommendations are incorporated. The following topics were systematically assessed based on the best available scientific evidence: primary diagnostics, reduction techniques, painmedication/ sedation surrounding reduction and the need for physiotherapy, stabilization surgery and immobilization...
April 17, 2024: Nederlands Tijdschrift Voor Geneeskunde
Michelle J M Janssen, Elsemieke Te Linde, Marjan W M Wassenberg, Marloes W Heijstek, Anke H W Bruns
Over one million people in The Netherlands are estimated having an immunodeficiency, of which the majority has an acquired immunodeficiency due to immunosuppressive medication. These patients are at risk for a more severe course of common infections, and also for opportunistic infections and viral reactivations. The following topics are discussed: types of immunodeficiency and how to estimate its severity; commonly seen infections in immunocompromised patients; recommended screening before start of immunosuppressive medication; pitfalls in clinical clues and diagnostics, and safety and immunogenicity of vaccination in these patients...
April 17, 2024: Nederlands Tijdschrift Voor Geneeskunde
Laura E De Wit, Roeland Vis, Laurien L Teunissen
About 20% of adults experience excessive daytime sleepiness or severe fatigue. Causes include somatic conditions, psychiatric disorders, and medication or drug use. Treatment depends on the underlying cause. If sleepiness persists despite optimal treatment of the underlying condition, exclusion of other causes, and behavioral interventions, wakefulness-promoting agents may be considered. However, no established pharmacological strategy exists for symptomatic treatment. Modafinil and stimulants like methylphenidate may offer some benefit based on experiences with narcolepsy or idiopathic hypersomnia...
April 16, 2024: Nederlands Tijdschrift Voor Geneeskunde
Dorianne M van Bruggen, David R M Jansen, Eveline P van Poelgeest
Sodium-glucose cotransporter 2 inhibitors (SGLT2 inhibitors) have gained prominence in the treatment of diabetes mellitus type 2, heart failure, and chronic kidney disease. However, concerns arise for frail older adults, given their underrepresentation in trials and heightened susceptibility to adverse drug events. This review summarizes the clinical effects of SGLT2 inhibitors in older adults with frailty. SGLT2 inhibitors seem to exhibit consistent cardiovascular benefits irrespective of age. As such, these drugs can be beneficial for older adults with 'cardiovascular frailty': in other words, cardiovascular multimorbidity...
April 11, 2024: Nederlands Tijdschrift Voor Geneeskunde
J C A Smit, Ira Helsloot, C Kramers
In 2008 in the Netherlands the Guideline 'Transmission of medication in the chain' was published. This guideline described that upon admission and discharge in the hospital verification of medication should take place. This caused significant investments in staff by hospitals to meet with this guideline. However, despite these efforts 15 years later this has not led to adequate transmission of medication. In this article it is described that the organization of medication verification in hospitals has features of the Risk Regulation Reflex...
April 10, 2024: Nederlands Tijdschrift Voor Geneeskunde
Zlatan Mujagic
OBJECTIVE: To investigate the biological mechanisms underlying the associations of psychological stress and intestinal inflammation in inflammatory bowel disease (IBD). DESIGN: Experimental mouse models and large human cohorts have been used. METHOD: Consecutive mouse models with chemically induced colitis were used to investigate biological pathways though which psychological stress leads to gut inflammation. These results were validated in three human cohorts with patients with IBD...
April 9, 2024: Nederlands Tijdschrift Voor Geneeskunde
Olaf M Dekkers, Rolf H H Groenwold
When a person dies in the Netherlands it is legally required to report the cause of death. In most cases however, there is uncertainty when classifying causes of death. Additional postmortem diagnostics such as a CT scan or autopsy do not always provide absolute certainty. Data on causes of death can be used to determine what are, on a population level, relevant health problems. One must be cautious to fully rely on these data for making policy or financing healthcare and research. Firstly, incorrectly classifying the cause of death can give a distorted view of the underlying causes...
April 8, 2024: Nederlands Tijdschrift Voor Geneeskunde
Mieke M Hulshof, Markus V Starink, Alexander S H J Lokin, Joppe W Hovius
During the past four decades the number of reported Lyme disease diagnoses in the Netherlands has increased to 27.000 a year, with a yearly incidence of Lyme disease between 111 (95% CI 106-115) to 131 (95% CI 126-136) per 100,000 person years. A large part of all Lyme disease diagnoses concern the skin; in the Netherlands, 77-89% erythema migrans, 2-3% borrelia lymfocytoom and 1-3% acrodermatitis chronica atrophicans. These skin manifestations have a variable clinical expression, reason why they can be difficult to diagnose...
April 3, 2024: Nederlands Tijdschrift Voor Geneeskunde
Jay M Bakas, Alexander L Kooiman, Marie Josee E van Rijn
Spontaneous retroperitoneal hematoma refers to bleeding of the retroperitoneal space without prior trauma or iatrogenic injury. Its diagnosis is often delayed due to a nonspecific clinical presentation. This case-series presents three patients with spontaneous retroperitoneal bleeding. Patient A presented with a spontaneous bleeding around the right iliopsoas muscle due to antiplatelet medication and was managed conservatively. Patient B had a spontaneous arterial bleeding near the right kidney, subsequently determined to be associated with a pheochromocytoma...
March 19, 2024: Nederlands Tijdschrift Voor Geneeskunde
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