Nederlands tijdschrift voor geneeskunde最新文献

Children with developmental delay develop more slowly than their peers in one or more developmental domains. This article discusses how to recognize developmental delay and key considerations for history taking, physical examination, and developmental assessment. The differential diagnosis is extensive; in addition to genetic, neurological and metabolic causes, developmental delay can result from acquired biological or social factors. The updated Dutch guideline 'Etiology of Developmental Delay and/or Intellectual Disability' (2025) outlines the diagnostic and therapeutic approaches. Children with developmental delay benefit from multidisciplinary therapy and special-needs education. The article also highlights the roles of various specialties within the care process.

Reactive lymphadenopathy after COVID-19 vaccination occurs frequently and usually recovers within 1-2 weeks. It can, however, persist for more than six months in some cases. Axillary lymphadenopathy at the site of vaccination is most common. Cervical and supraclavicular lymphadenopathy is also reported. A wait-and-see approach for 2-3 weeks seems justified when time between onset of lymphadenopathy and covid-19 vaccination is several days to weeks, there is no progression, lymphadenopathy is unilateral and localised axillary or cervical in patients without a history of malignancy and without alarm symptoms. In cases of persistent lymphadenopathy, ultrasound of the affected lymph node is recommended. In cases of unilateral axillary lymphadenopathy in women, breast examination with mammography and/or breast ultrasound is also warranted. In the absence of any abnormalities referral to secondary care can be delayed for 8-12 weeks. After this time period we advise referral to secondary care to exclude any underlying illness.

Objective: Gain insight into usage, environmental impact and user experience of different absorbent mats.

Design: Prospective implementation study and life cycle assessments (LCAs).

Method: Conducted at the LUMC and UMCG, insight into usage of disposable cellulose pads was obtained through focus groups, interviews and surveys. LCAs analysed the environmental impact of disposable and reusable mats. User experience was evaluated through surveys for patients and healthcare professionals. Finally, functionality and usage trends were evaluated.

Results: Findings reveal that disposable pads are often used for incorrect indications due to convenience and ineffective safety behaviour. The reusable mat has a lower environmental impact than the disposable pad. After implementing the reusable mat, a reduction in usage numbers is acquired and usage is perceived positively.

Conclusion: The environmental impact of absorbent mats in healthcare can be reduced by using them more efficiently and replacing them with reusable mats while maintaining a positive user experience.

A 38-year-old man presented with a painful swelling in the left groin radiating to the scrotum for three days. Suspecting an incarcerated inguinal hernia, an exploration was performed in the operating room, which revealed vasitis (inflammation of the vas deferens) instead. A urine culture (including an STI test) was obtained, and an empirical 14-day course of ciprofloxacin was initiated.

Neurocutaneous dysesthesia manifests as abnormal sensations, such as itching, pain, or burning, often without visible skin lesions. The condition is caused by peripheral or central nerve damage or compression. There are many different forms of neurocutaneous dysesthesia, depending on the location and the nerves involved. A well-known example is post-herpetic neuralgia, whereas brachioradial pruritus and notalgia paresthetica are less recognized. Diagnosis requires a thorough medical history and recognition of typical clinical patterns. Treatment ranges from local therapies to systemic agents.

In this article, we explore how the genderhealth gap has developed from a cultural-historical perspective, through the lens of a general practitioner, health scientist and medical historian. We describe the application of the concept of 'the collective memory' to medicine as a discipline, and show how it shapes medicine's identity. Awareness of the collective memory reveals underlying biases and could result in a sustainable and systematic change in medicine that ultimately improves the health of both women and men. When physicians critically examine the past in collaboration with historians, room to reflect on current practices is created. Why do we think the way we think, and act the way we act? This collaborative examination of the past allows us to understand the roots of the genderhealthgap and to work towards increasingly gender-sensitive medicine.

This case concerns a 66-year old man with lower abdominal and groin pain and bilateral spontaneous flank ecchymoses, based on a spontaneous bilateral iliopsoas hematoma. This case illustrates that, although uncommon, an iliopsoas hematoma can be the cause of a Grey Turner sign, indicating a retroperitoneal haemorrhage.

Pediatric hip fractures are rare and pose significant clinical challenges in their treatment. These fractures typically result from high-energy trauma, while low-energy mechanisms should raise suspicion for pathological fractures or non-accidental injury. Pediatric hip fractures are associated with high complication rates, including avascular necrosis, coxa vara, non-union, and leg-length discrepancies. These complications arise from the unique anatomy of the proximal femur in children, particularly the presence of the growth plate and the vulnerable arterial blood supply. Early surgical intervention with anatomic reduction and stable internal fixation is crucial. This review article summarizes the key principles of pediatric hip fracture management and the potential complications.

Persistent somatic symptoms (PSS) is an umbrella term for physical symptoms lasting several months that limit daily functioning or cause significant distress, regardless of their etiology. Treatment can be effective, but in refractory PSS, which is often accompanied by severe functional impairments, treatment may fail or even have adverse effects. In clinical practice, inpatient admission is often considered in such cases. Two case studies illustrate the challenges and outcomes of inpatient treatment for refractory PSS. Patient A benefited from a structured and planned biopsychosocial approach, which led to improved functioning and reduced suicidality. In contrast, Patient B had a negative experience due to the absence of jointly established expectations and disappointment with the diagnostic procedures. These cases highlight the importance of a well-prepared admission process, in which the patient, relatives, and involved healthcare professionals discuss expectations and reach agreement on concrete goals to enable an effective start to the recovery process.

Chronic conditions represent an increasing public health challenge. While concepts like person-centered care, shared decision-making, and self-management are increasingly promoted, their practical realization remains difficult within our disease-centered healthcare system. The Assessment of Burden of Chronic Conditions (ABCC) tool may contribute to a more person-centered approach within the current healthcare system. This tool can support patients and healthcare providers in developing personalized care plans by measuring and visualizing perceived disease burden. Research indicates that the questions within the ABCC tool are valid and reliable for COPD, asthma, type 2 diabetes, chronic heart failure, osteoarthritis, and colorectal cancer. An effectiveness study found that using the tool resulted in significant differences in perceived quality of care and patient activation compared to control. However, outcomes like quality of life and well-being showed no significant differences in this study. Future research should focus on validation for multimorbidity, long-term effects, and implementation strategies.