Evaluating the effect of cannabidiol on sleep quality in patients with multiple sclerosis using 15 aggregated N-of-1 trials: A study protocol.

Background: Sleep disorders, including insomnia, are highly prevalent in individuals with multiple sclerosis (MS), significantly impacting quality of life. Patients frequently use cannabidiol (CBD) as an alternative to standard medical treatments for sleep disorders, yet its efficacy has not been rigorously investigated.

Methods: This study comprises 15 randomized, placebo-controlled N-of-1 trials evaluating the effect of pure CBD oil (10 % g/v) on sleep quality in MS patients.

Effectiveness and user experiences of a valgus brace in patients with knee osteoarthritis: A mixed-method randomised controlled trial.

Background: Patients with medial compartment knee osteoarthritis (OA) may benefit from wearing a valgus brace, but previous studies lacked consideration for brace wearing time, co-interventions and the brace users' perceptions. This mixed-method randomised controlled trial investigated the effectiveness of a valgus brace on knee pain and activity limitations alongside exploring user perceptions.

Materials And Methods: Participants randomised to the intervention group (n = 23) received regular care and a customisable valgus brace for 6 months while the participants randomised to the waitlist control group (n = 23) were allowed any regular care treatment except for a knee brace.

Hypertensive retinopathy in Dutch emergency departments: a multicenter retrospective cohort analysis.

Suspected hypertensive emergencies account for approximately one in every 200 emergency department (ED) visits in the Netherlands. One manifestation of hypertensive-mediated organ damage (HMOD) is hypertensive retinopathy. A rapid and aggressive reduction in blood pressure in these patients can result in severe cerebral complications, however a clear clinical definition is lacking, resulting in a heterogeneous patient population and ongoing debate regarding the necessity of intravenous therapy in these cases.

How do patients and health care professionals perceive de-implementation of routine follow-ups after total hip or knee arthroplasty? Protocol for a nested qualitative study within a hybrid effectiveness de-implementation trial.

Background: Total hip and knee arthroplasties significantly improve the quality of life for patients with severe osteoarthritis. However, some patients experience complications that require follow-up care. Amid rising demand for these arthroplasties, debates have emerged around the value of routinely scheduled follow-ups (RFUs).

Sustained Improvement of Cognition, Mood and Plasma Markers Three Years After Metabolic Bariatric Surgery. The BARICO Study.

Background: The primary aim of this study is to investigate the impact of MBS induced weight loss on cognition, and secondary investigate the impact of this weight loss on adipokines, inflammatory factors, vascular markers, mood and physical activity three years after MBS.

Methods: This observational study assessed data from 107 patients with severe obesity (aged 35 to 55 years) from the BARICO (BAriatric surgery Rijnstate and Radboudumc neuroImaging and Cognition in Obesity) study, eligible for Roux-en-Y gastric bypass. Data were collected before, and at 6, 24 and 36 months after MBS.

Four-dimensional Computed Tomography Imaging in Primary Hyperparathyroidism: Multireader Multicase Study of Both Neuroradiologists and General Radiologists of Imaging Approaches With Less Phases.

Objective: Primary hyperparathyroidism (PHPT) is commonly caused by parathyroid adenomas (PAs), and four-dimensional computed tomography (4DCT) is increasingly used for localising PAs due to its high sensitivity and specificity. However, the relative high radiation dose of 4DCT may limit its widespread use as first line imaging in some settings. A reduced phase protocol and enhancement maps, which highlight relative enhancement differences between the nonenhanced and arterial phases, have been proposed as ways to reduce radiation exposure without compromising diagnostic accuracy.

Nurses' experiences with inhospital continuous monitoring of vital signs in general wards: A systematic review.

Recent developments make the continuous monitoring of vital signs outside the critical care setting feasible, and may provide a benefit in terms of improved patient outcomes and cost efficiency. A meta-aggregative systematic review was conducted to provide an overview of the experiences of nurses working with continuous monitoring of vital signs in patients admitted to a hospital general ward. All study designs describing nurses' experiences in a qualitative manner were included.

Cost-Utility Analysis of Treatment Sequences for Moderate-to-Severe Crohn's Disease.

Objectives: The clinical pathway for patients with moderate-to-severe Crohn's disease (CD) typically includes sequential pharmacologic treatment as well as surgery, but positioning of different therapies within these sequences remains challenging. Cost-utility analysis rarely captures these sequences and does not incorporate registry data on long-term effectiveness. In this study, we aim to overcome these limitations.

Absorption of apixaban following metabolic bariatric surgery: is reluctance still warranted?

Background: Absorption of apixaban, a direct oral anticoagulant (DOAC), may be impaired after metabolic and bariatric surgery (MBS). The Dutch guideline advises to switch to vitamin K antagonists (VKA), while patients prefer the use of DOACs. Apixaban is not regularly prescribed after MBS due to a lack of evidence regarding its efficacy and safety.

The long-term effect of metabolic bariatric surgery on innate immune cell phenotype and function.

Objectives: Obesity is an important risk factor for atherosclerotic cardiovascular disease. This cardiovascular risk remains increased even after substantial weight loss by bariatric surgery. Innate immune cells are important regulators of atherogenesis and can adopt a long-term hyperinflammatory phenotype via epigenetic reprogramming, called "trained immunity".

Atypical lymphoid proliferations associated with therapeutic intervention: a report of the 2024 EA4HP/SH lymphoma workshop.

The challenging boundaries between neoplastic and reactive lymphoproliferations were discussed during the 2024 European Association for Haematopathology/Society for Hematopathology workshop in Dubrovnik, Croatia. Session 3 focussed on the atypical lymphoid proliferations associated with therapeutic interventions. Forty-four cases were submitted representing a broad spectrum of lymphoproliferative disorders (LPDs) encountered in the settings of immunosuppressive and immunomodulatory therapies, various interventions for solid tumor treatment, drug reaction with eosinophilia and systemic symptoms (DRESS), CAR T-cell therapy for B-cell lymphomas, Bruton tyrosine kinase inhibitors (BTKI) for SLL/CLL treatment, ABL-kinase inhibitor dasatinib, and COVID-19 vaccination.

Getting valuable and valid insight in life after ICU: Evaluating the representativeness of a large cohort of ICU survivors.

Background: Measuring patient-reported outcome measures (PROMs) is essential for improving intensive care medicine, but it is challenging and prone to bias. This study investigates the representativeness of a multicenter, PROM-based cohort of Intensive Care Unit (ICU) survivors.

Methods: Demographic, clinical and ICU admission characteristics of the multicenter, PROM-based cohort (n = 6 ICUs) were compared to those of all ICU survivors in Dutch hospitals (n = 73 ICUs), in the years 2019 and 2022, based on data from the National Intensive Care Evaluation registry.

Similar gout flare incidence rates when using once- or twice-daily 0.5 mg colchicine prophylaxis after the start of xanthine oxidase inhibitors.

Objective: To investigate the potential superiority of colchicine prophylaxis twice daily over once daily in preventing gout flares in the first 6 months after initiating xanthine oxidase inhibitors (XOIs).

Method: A retrospective cohort study was conducted in three rheumatology centres in the Netherlands. Gout flare incidence densities were calculated for patients using colchicine once or twice daily in the first 6 months after starting XOIs.

Bridging the Gap: Evaluating Tools for Adherence to Dietary-Related Behavioral Recommendations After Metabolic Bariatric Surgery-A Scoping Review.

Background And Aims: Adherence to dietary-related behavioral recommendations following metabolic bariatric surgery (MBS) is important for achieving optimal surgical outcomes, but standardized definitions and tools are lacking. This scoping review aimed to map existing tools for assessing adherence to dietary-related behavioral recommendations after MBS, evaluate their content and psychometric properties, and identify gaps to guide future research and tool development.

Methods: The review was registered on the Open Science Framework and followed PRISMA-ScR guidelines.

Identifying distinct clusters of ICU survivors by integrating demographic, pre-admission quality of life, and clinical data: a large prospective cohort study.

Purpose: ICU patients differ in pre-ICU health status, comorbidities, and diagnosis, forming a heterogeneous population with diverse long-term outcomes. This study explored whether clustering ICU patients by demographic, pre-admission quality of life, and clinical data, rather than by diagnosis, could identify subgroups that are more informative for patient-centered outcomes post-ICU.

Methods: Data from the MONITOR-IC prospective cohort study were used.

History of Pregnancy Complications and the Risk of Ischemic Stroke in Young Women.

Background And Objectives: Pregnancy complications, such as hypertensive disorders of pregnancy (HDP), small for gestational age (SGA), preterm birth, gestational diabetes, stillbirth, and miscarriage, may increase the risk of ischemic stroke several years later. The aim of this study was to quantify the association between a spectrum of pregnancy complications and (the cause of) ischemic stroke in young women (<50 years).

Methods: This study included 358 women (18-49 years) with first-ever imaging-proven ischemic stroke from the Observational Dutch Young Symptomatic StrokE study and 714 women from the Pregnancy and Infant Development Study, frequency-matched on age at most recent pregnancy and gravidity.

Cognitive rehabilitation after out-of-hospital cardiac arrest: combining metacognitive strategy and direct training to improve daily cognitive functioning.

Objective: Approximately half of out-of-hospital cardiac arrest (OHCA) survivors have enduring cognitive impairment. This study investigated the effectiveness of a combined cognitive rehabilitation approach, combining metacognitive strategy training with direct computerized-training, to improve cognitive functioning in daily life after OHCA.

Method: A single-case experimental design with a non-concurrent multiple baseline was used including five participants.

Influence of Survivorship Care on Health-Related Quality of Life, Knowledge of Late Effects, and Distress Levels Among Long-Term Hodgkin Lymphoma Survivors.

Introduction: Hodgkin lymphoma (HL) is a highly curable malignancy mainly affecting young adults, but survivors are at risk of serious late adverse effects, like cardiovascular disease and subsequent malignancies, which may impact health-related quality of life (HRQoL). The Dutch BETER consortium introduced a nationwide survivorship care program offering tailored screening for late effects among HL survivors from 5 years after diagnosis onward. This study evaluates the association between BETER survivorship care and HRQoL, knowledge of late effects, and distress levels.

Timing of invasive strategy in patients with non-ST segment elevation acute myocardial infarction: A nationwide retrospective cohort analysis.

Background: The Dutch ACS working group endorses a delayed invasive approach for non-ST segment elevation myocardial infarction (NSTEMI) patients as safe and acceptable. We analysed the timing of invasive coronary angiography (ICA) and percutaneous coronary intervention (PCI) for all patients admitted with NSTEMI.

Methods: For this retrospective observational cohort study initiated by the Netherlands Heart Registration, we extracted Dutch medical claims and diagnosis codes for all NSTEMI patients who underwent PCI.

Evaluation of a Predictive Model and Clinical Outcomes in Mild Acute Pancreatitis: Towards Evidence-Based Early Discharge.

Background: Given that the care for mild acute pancreatitis (AP) patients is often supportive, these patients may, due to the current strain on hospital care, be eligible for early hospital discharge. However, timely identification of this population and information about their clinical course is needed. This study aims to identify a reliable method for predicting a mild course at 24 and 48 h after hospitalization and to assess clinical outcomes to optimize future early discharge strategies.

The new frontier of MRI: virtual dissection with 3D-PDw sequence. A pilot study on ATiFL anatomy.

Purpose: There is much conflicting data regarding the anatomy of the anterior tibiofibular ligament (ATiFL), even in studies with anatomical specimens. Therefore, this study aims to reassess the anatomy of this ligament using a high-resolution isotropic 3D-PDw MRI sequence.

Methods: From February to May 2024, 72 MRI scans (3 T) of the ankle were performed at Amsterdam UMC.

Atypical lymphoproliferations associated with germline genetic variants: a report of the 2024 EA4HP/SH lymphoma workshop.

Session 2 of the 2024 European Association for Haematopathology/Society for Hematopathology lymphoma workshop was dedicated to atypical lymphoproliferations in association with germline genetic variants. The first group of cases were lymphoproliferations occurring in the context of primary immunodeficiencies (PID), a heterogeneous group of diseases with increasing incidence and number of different diseases due to better recognition. The workshop contained a spectrum of different PIDs and associated lymphoproliferations with autoimmune lymphoproliferative syndrome, activated phosphoinositide 3-kinase delta syndrome, ataxia-telangiectasia and common variable immune deficiency being the most common.