{"title":"Uit de oude doos: Praatjes in de wind - oktober 1946","authors":"B. Vandekerkhove","doi":"10.47671/tvg.77.20.183","DOIUrl":"https://doi.org/10.47671/tvg.77.20.183","url":null,"abstract":"","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"43 2-3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140489866","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}
Treatment of opioid addiction in pregnancy with buprenorphine: implications for the fetus and newborn The aim of this article is to summarize the actual knowledge on the use of buprenorphine for the treatment of opioid addiction in pregnancy. Buprenorphine is a semisynthetic thebaine derivative, increasingly used instead of methadone for the treatment of opioid-dependent pregnant women. Fetuses exposed to buprenorphine have a more favorable biophysical profile compared to methadone. The neonatal abstinence syndrome (NAS) occurs less in comparison to methadone-exposed neonates. Treatment is not always indicated and, if necessary, morphine is administered. Buprenorphine is a promising alternative to methadone in the treatment of pregnant women with opioid addiction.
{"title":"Behandeling van opioïdverslaafde zwangere vrouwen met buprenorfine: invloed op de foetus en de pasgeborene","authors":"L. El-Bazioui, L. Terryn, K. Smets","doi":"10.47671/tvg.79.23.106","DOIUrl":"https://doi.org/10.47671/tvg.79.23.106","url":null,"abstract":"Treatment of opioid addiction in pregnancy with buprenorphine: implications for the fetus and newborn\u0000\u0000 \u0000\u0000The aim of this article is to summarize the actual knowledge on the use of buprenorphine for the treatment of opioid addiction in pregnancy. Buprenorphine is a semisynthetic thebaine derivative, increasingly used instead of methadone for the treatment of opioid-dependent pregnant women. Fetuses exposed to buprenorphine have a more favorable biophysical profile compared to methadone. The neonatal abstinence syndrome (NAS) occurs less in comparison to methadone-exposed neonates. Treatment is not always indicated and, if necessary, morphine is administered. Buprenorphine is a promising alternative to methadone in the treatment of pregnant women with opioid addiction.","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"77 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139526378","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}
Factors associated with externalizing challenging behaviour in children and adolescents with ASD: a systematic review Autism spectrum disorder (ASD) is a neurodevelopmental syndrome with a high prevalence of comorbid challenging behaviours. Externalizing challenging behaviours are known to have a negative prognostic impact on children with ASD and their caregivers. Studies have shown several risk factors for externalizing challenging behaviours in the typically developing population. Less is known about the risk factors for children with ASD. The databases PubMed, Embase and Web of Science Core Collection were systematically searched. A systematic analysis of the selected articles was performed. A total of 95 studies were found. Despite the multitude of withheld articles, only a few factors showed to be clearly associated with externalizing challenging behaviour in children with ASD. The studies in this review mainly investigate cross-sectional and some prognostic associations, and often find conflicting results. Consequently, the authors cannot make strong statements about possible direct causal relationships of the studied factors with externalising behavioural problems. Nevertheless, they emphasize some possible implications for clinical practice. First, more attention should be paid to the adaptive skills of children with ASD. In addition, they underline the importance of systematic screening regarding the severity of the rigidity, encouraging flexibility and learning to cope with change. Furthermore, it is crucial to diagnose and treat ADHD and sleep disorders. Finally, the results mark the importance of early detection and intervention of contextual factors.
自闭症谱系障碍（ASD）是一种神经发育综合症，合并挑战行为的发生率很高。众所周知，外化挑战行为会对自闭症谱系障碍儿童及其照顾者的预后产生负面影响。研究表明，在发育正常的人群中，有几种风险因素会导致外化挑战行为。但对 ASD 儿童的风险因素了解较少。我们系统地检索了 PubMed、Embase 和 Web of Science Core Collection 等数据库。对所选文章进行了系统分析。共发现 95 项研究。尽管文章数量众多，但只有少数因素与 ASD 儿童的外化挑战行为有明显关联。本综述中的研究主要调查横断面和一些预后关联，结果往往相互矛盾。因此，作者无法就所研究的因素与外化行为问题之间可能存在的直接因果关系做出有力的论断。不过，他们强调了一些可能对临床实践产生的影响。首先，应更加关注 ASD 儿童的适应能力。此外，他们还强调了系统筛查僵化程度、鼓励灵活性和学习应对变化的重要性。此外，诊断和治疗多动症和睡眠障碍也至关重要。最后，研究结果表明了早期发现和干预环境因素的重要性。
{"title":"Factoren geassocieerd aan agressiviteit en verwante gedragsproblemen bij kinderen en adolescenten met ASS: een grondige review","authors":"J. Haas, J. Steyaert, M. Danckaerts","doi":"10.47671/tvg.79.23.108","DOIUrl":"https://doi.org/10.47671/tvg.79.23.108","url":null,"abstract":"Factors associated with externalizing challenging behaviour in children and adolescents with ASD: a systematic review\u0000\u0000 \u0000\u0000Autism spectrum disorder (ASD) is a neurodevelopmental syndrome with a high prevalence of comorbid challenging behaviours. Externalizing challenging behaviours are known to have a negative prognostic impact on children with ASD and their caregivers. Studies have shown several risk factors for externalizing challenging behaviours in the typically developing population. Less is known about the risk factors for children with ASD.\u0000\u0000 \u0000\u0000The databases PubMed, Embase and Web of Science Core Collection were systematically searched. A systematic analysis of the selected articles was performed.\u0000\u0000 \u0000\u0000A total of 95 studies were found. Despite the multitude of withheld articles, only a few factors showed to be clearly associated with externalizing challenging behaviour in children with ASD.\u0000\u0000 \u0000\u0000The studies in this review mainly investigate cross-sectional and some prognostic associations, and often find conflicting results. Consequently, the authors cannot make strong statements about possible direct causal relationships of the studied factors with externalising behavioural problems. Nevertheless, they emphasize some possible implications for clinical practice. First, more attention should be paid to the adaptive skills of children with ASD. In addition, they underline the importance of systematic screening regarding the severity of the rigidity, encouraging flexibility and learning to cope with change. Furthermore, it is crucial to diagnose and treat ADHD and sleep disorders. Finally, the results mark the importance of early detection and intervention of contextual factors.","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"36 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139532226","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}
Rare nasal and nasopharyngeal manifestation of extranodal Rosai-Dorfman disease: a case report Rosai-Dorfman disease (RDD) is a rare histiocytic proliferative neoplastic process, characterized by a massive accumulation of histiocytes in lymph nodes. Extranodal involvement may also occur. However, isolated extranodal RDD (ENRDD) is relatively uncommon. Commonly affected extranodal sites are the skin, the central nervous system and the head and neck region. The most common otolaryngologic locations for extranodal manifestation are the sinonasal compartment and the pharynx. RDD patients with (para)nasal cavity masses present symptoms of progressive nasal obstruction, recurrent epistaxis, facial pain or hyposmia. The disease is characterized by a relapsing and remitting course that is usually self-limiting. Emergent molecular studies have shown an important role of the MAPK/ERK pathway. Histopathologic evaluation is the main diagnostic modality: the characteristic histiocytes are S-100+, CD68+ and CD1a- and show a variable frequency of emperipolesis. There are no guidelines regarding the optimal treatment strategy. RDD is a heterogeneous entity that can occur as an isolated disorder or in association with autoimmune, hereditary or malignant diseases. This article discusses the case of a patient with isolated ENRDD. A 32-year-old man presented with a left nasal mass, nasal septum involvement and a mass at the left nasopharynx. The diagnosis was made after histopathological examination. ENRDD is a rare, benign disease entity with a varied clinical profile. Consequently, RDD can present a diagnostic challenge and may lead to misdiagnosis.
{"title":"Nasale en nasofaryngeale extranodale manifestatie van de ziekte van Rosai-Dorfman: een casusbespreking","authors":"M. Moyaert, A. Van Boven, G. De Vos","doi":"10.47671/tvg.79.23.100","DOIUrl":"https://doi.org/10.47671/tvg.79.23.100","url":null,"abstract":"Rare nasal and nasopharyngeal manifestation of extranodal Rosai-Dorfman disease: a case report\u0000\u0000 \u0000\u0000Rosai-Dorfman disease (RDD) is a rare histiocytic proliferative neoplastic process, characterized by a massive accumulation of histiocytes in lymph nodes. Extranodal involvement may also occur. However, isolated extranodal RDD (ENRDD) is relatively uncommon.\u0000\u0000 \u0000\u0000Commonly affected extranodal sites are the skin, the central nervous system and the head and neck region. The most common otolaryngologic locations for extranodal manifestation are the sinonasal compartment and the pharynx. RDD patients with (para)nasal cavity masses present symptoms of progressive nasal obstruction, recurrent epistaxis, facial pain or hyposmia.\u0000\u0000 \u0000\u0000The disease is characterized by a relapsing and remitting course that is usually self-limiting.\u0000\u0000Emergent molecular studies have shown an important role of the MAPK/ERK pathway.\u0000\u0000Histopathologic evaluation is the main diagnostic modality: the characteristic histiocytes are S-100+, CD68+ and CD1a- and show a variable frequency of emperipolesis. There are no guidelines regarding the optimal treatment strategy.\u0000\u0000 \u0000\u0000RDD is a heterogeneous entity that can occur as an isolated disorder or in association with autoimmune, hereditary or malignant diseases.\u0000\u0000 \u0000\u0000This article discusses the case of a patient with isolated ENRDD. A 32-year-old man presented with a left nasal mass, nasal septum involvement and a mass at the left nasopharynx. The diagnosis was made after histopathological examination.\u0000\u0000 \u0000\u0000ENRDD is a rare, benign disease entity with a varied clinical profile. Consequently, RDD can present a diagnostic challenge and may lead to misdiagnosis.","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"18 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139443495","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}
I. Schoolmeesters, K. Kempeneers, B. Sciot, X. Huybrechts
Lumbago as a symptom of an extramedullary tumour in acute myeloid leukaemia A 58-year-old man with acute myeloid leukaemia presents with low back pain. Because of his oncologic history and severe pain during the night, additional radiographic imaging was performed. These alarm signals or so-called red flags are described in the guidelines of the Belgian Health Care Knowledge Centre (KCE). Imaging showed a mass at the 10th thoracic vertebra, suspected to be an extramedullary tumour consisting of myeloblasts, originating from the previously diagnosed acute myeloid leukaemia. A biopsy confirmed this diagnosis. Since these tumours present with different symptoms and at different locations, every physician should be aware of them. They are treated systemically with chemotherapy, like the intramedullary disease, sometimes supplemented with local therapy. In some cases, this disease manifestation presents prior to or without the diagnosis of acute myeloid leukaemia. A correct histological diagnosis is then essential for a correct treatment.
{"title":"Lumbalgie als symptoom van een extramedullaire tumor bij acute myeloïde leukemie","authors":"I. Schoolmeesters, K. Kempeneers, B. Sciot, X. Huybrechts","doi":"10.47671/tvg.79.23.098","DOIUrl":"https://doi.org/10.47671/tvg.79.23.098","url":null,"abstract":"Lumbago as a symptom of an extramedullary tumour in acute myeloid leukaemia\u0000\u0000 \u0000\u0000A 58-year-old man with acute myeloid leukaemia presents with low back pain. Because of his oncologic history and severe pain during the night, additional radiographic imaging was performed. These alarm signals or so-called red flags are described in the guidelines of the Belgian Health Care Knowledge Centre (KCE). Imaging showed a mass at the 10th thoracic vertebra, suspected to be an extramedullary tumour consisting of myeloblasts, originating from the previously diagnosed acute myeloid leukaemia. A biopsy confirmed this diagnosis.\u0000\u0000 \u0000\u0000Since these tumours present with different symptoms and at different locations, every physician should be aware of them. They are treated systemically with chemotherapy, like the intramedullary disease, sometimes supplemented with local therapy. In some cases, this disease manifestation presents prior to or without the diagnosis of acute myeloid leukaemia. A correct histological diagnosis is then essential for a correct treatment.","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"65 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139450068","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}
{"title":"Artificiële intelligentie in de geneeskunde","authors":"P. Lacor","doi":"10.47671/tvg.79.23.128","DOIUrl":"https://doi.org/10.47671/tvg.79.23.128","url":null,"abstract":"","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"117 38","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139133476","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}
{"title":"Glutenovergevoeligheid als gevolg van alarmerende berichten in de media","authors":"M. Finoulst, P. Vankrunkelsven, D. De Looze","doi":"10.47671/tvg.79.23.130","DOIUrl":"https://doi.org/10.47671/tvg.79.23.130","url":null,"abstract":"","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"91 s1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139145745","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}
{"title":"Folia Pharmacotherapeutica januari 2024","authors":"","doi":"10.47671/tvg.79.23.129","DOIUrl":"https://doi.org/10.47671/tvg.79.23.129","url":null,"abstract":"","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":" 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139143055","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}
B. Forier, E. Claeys, B. Santens, M. Dumoulein, M. Leys
An unusual cause of acute desaturation A 61-year-old man presented with symptoms of rapidly increasing dyspnea, chest pain and significant hypoxemia for which the initial investigations revealed no clear explanation. There was a remarkable improvement of the saturation in supine position. A contrast transesophageal echocardiography established the presence of a patent foramen ovale (PFO), which was successfully closed via a percutaneous transcatheter. Platypnoea-orthodeoxia syndrome (POS) is a rare entity characterized by the presence of arterial hypoxemia in upright position with resolution of the hypoxemia in supine position. It is most frequently caused by a PFO. A PFO is, however, merely an essential precondition and the development of POS nearly always requires the presence of other (functional) factors.
{"title":"Een ongebruikelijke oorzaak van acute desaturatie","authors":"B. Forier, E. Claeys, B. Santens, M. Dumoulein, M. Leys","doi":"10.47671/tvg.79.23.095","DOIUrl":"https://doi.org/10.47671/tvg.79.23.095","url":null,"abstract":"An unusual cause of acute desaturation A 61-year-old man presented with symptoms of rapidly increasing dyspnea, chest pain and significant hypoxemia for which the initial investigations revealed no clear explanation. There was a remarkable improvement of the saturation in supine position. A contrast transesophageal echocardiography established the presence of a patent foramen ovale (PFO), which was successfully closed via a percutaneous transcatheter. Platypnoea-orthodeoxia syndrome (POS) is a rare entity characterized by the presence of arterial hypoxemia in upright position with resolution of the hypoxemia in supine position. It is most frequently caused by a PFO. A PFO is, however, merely an essential precondition and the development of POS nearly always requires the presence of other (functional) factors.","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"65 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139155887","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}
Unexpected methylphenidate-induced uterine bleeding In most countries, methylphenidate appears to be the main pharmacological treatment for attention deficit hyperactivity disorder (ADHD). The global prevalence of ADHD is estimated to be approximately 2.5% in adults and 5-7% in children. This case report examines the link between the initiation of extended-release methylphenidate and the occurrence of unexpected uterine bleeding in a patient, aiming to determine if there is any scientific basis for considering this symptom as a side effect of methylphenidate. Although there are some suspicions in the literature, the evidence is still too limited to explain a causal relationship between methylphenidate and unexpected uterine bleeding. In recent years, scientific studies have shown a growing awareness of ADHD in the female population, while women and girls were previously diagnosed with ADHD much less frequently and much later. However, this phenomenon of underrepresentation of women still occurs in the available scientific literature, especially in somewhat older studies. In future research, an important challenge lies in further monitoring any potential effects of methylphenidate on the female reproductive system, adequately reporting contraceptive use in study populations, as well as detailing all adverse events and reasons for study dropouts.
{"title":"Onverwacht uterien bloedverlies bij methylfenidaat","authors":"I. Gybels, F.-L. De Winter, Y. Meuffels","doi":"10.47671/tvg.79.23.092","DOIUrl":"https://doi.org/10.47671/tvg.79.23.092","url":null,"abstract":"Unexpected methylphenidate-induced uterine bleeding\u0000\u0000 \u0000\u0000In most countries, methylphenidate appears to be the main pharmacological treatment for attention deficit hyperactivity disorder (ADHD). The global prevalence of ADHD is estimated to be approximately 2.5% in adults and 5-7% in children. This case report examines the link between the initiation of extended-release methylphenidate and the occurrence of unexpected uterine bleeding in a patient, aiming to determine if there is any scientific basis for considering this symptom as a side effect of methylphenidate. Although there are some suspicions in the literature, the evidence is still too limited to explain a causal relationship between methylphenidate and unexpected uterine bleeding. In recent years, scientific studies have shown a growing awareness of ADHD in the female population, while women and girls were previously diagnosed with ADHD much less frequently and much later. However, this phenomenon of underrepresentation of women still occurs in the available scientific literature, especially in somewhat older studies. In future research, an important challenge lies in further monitoring any potential effects of methylphenidate on the female reproductive system, adequately reporting contraceptive use in study populations, as well as detailing all adverse events and reasons for study dropouts.","PeriodicalId":23124,"journal":{"name":"Tijdschrift Voor Geneeskunde","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138944955","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}
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