Publications by authors named "Numans M"

Background & Aims: This study aimed to assess whether a fasting-mimicking diet (FMD) programme as an adjunct to usual care can reduce liver fat and liver inflammation/fibrosis as measured by Magnetic Resonance Imaging (MRI) in patients with type 2 diabetes.

Methods: This study analyses secondary outcomes of the Fasting In diabetes Treatment (FIT) trial, which was a randomised, controlled, assessor-blinded trial in which people with type 2 diabetes using metformin only and/or diet alone for glycaemic control were randomised to receive 5-consecutive day cycles of FMD monthly as adjunct to usual care or usual care only for twelve months. Laboratory measurements, anthropometric measurements and MRI were performed at baseline, 6 and 12 months.

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Background And Aims: Type 2 diabetes is associated with a heightened risk of cardiovascular complications, including myocardial steatosis. Fasting-mimicking diets (FMDs) may mimic the metabolic benefits of fasting, while being less intensive than fasting. This study aims to investigate the effect of following an FMD program on myocardial triglyceride content (MTGC), as assessed by Magnetic Resonance Spectroscopy (MRS), in patients with type 2 diabetes.

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Background: Routine body mass index (BMI) recording in electronic health records (EHR) could support general practitioners (GPs) in managing patients with obesity. This study aimed to evaluate recording practices of BMI, overweight, and obesity in adults including subgroup analysis of age, sex, and comorbidities in primary care in the Netherlands.

Methods: An observational study of individuals aged ≥ 18 years and registered between 2007 and 2023, using routine healthcare data from the Extramural LUMC Academic Network (ELAN) in the Netherlands.

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Objectives: Educational initiatives in residency may lack alignment with residents' learning objectives. Furthermore, they may overlook residents' struggle to find fulfilment in their work. Professional identity formation (PIF) is a conceptual lens through which to explore the alignment of educational initiatives with residents' learning objectives.

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Background: This study aimed to explore the impact of the COVID-19 pandemic and resulting changes to diabetes care, especially concerning disease control, the use of (tele)consultation and lessons worth implementing to improve diabetes care, with a specific focus on ethnic minority groups.

Methods: A mixed-methods prospective cohort study among people with type 2 Diabetes Mellitus (T2DM) treated in primary care during the COVID-19 pandemic. A survey was sent regionally, including items related to teleconsultation and amount of contact with the healthcare professional.

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Background: The COVID-19 lockdown had profound effects on society and healthcare. Cardiology departments reported declines in chest pain evaluations and acute coronary syndrome (ACS) diagnoses. However, the pattern of chest pain in primary care is not clear yet.

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Article Synopsis
  • Advance care planning (ACP) is important for empowering patients with chronic diseases to express their care preferences, but it's not consistently implemented in general practice.
  • A study involving Dutch GP residents used virtual simulation to explore their experiences with ACP conversations, revealing that while the simulation lacked realism, it helped residents understand which topics to discuss.
  • The findings suggest that virtual simulations, alongside critical reflection and practice with real patients, are essential for enhancing GP residents' skills in conducting ACP conversations.
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Aim: Although South Asians have an increased risk to develop diabetes, data on the difference in development and progression of diabetic nephropathy between ethnic groups are not consistent. The aim of this study was to evaluate possible differences in the development and progression of albuminuria in South Asians and Western Europeans (WE) with type 2 diabetes in a large closed cohort of South Asians with type 2 diabetes.

Methods: Data on 1269 South Asians and 2272 Dutch adults with type 2 diabetes who were treated in our diabetes clinic in 2006 or referred thereafter were extracted from electronic medical records.

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Article Synopsis
  • This study investigates the occurrence, symptom patterns, and factors influencing post-acute COVID symptoms in a sample of the Dutch population using data from the COVID RADAR app.
  • The research included 1478 participants who recorded their symptoms from 40 days before to 100 days after a positive COVID test, identifying cough, loss of smell or taste, and fatigue as the most common ongoing symptoms.
  • The findings revealed that about 8% of participants still had symptoms after 100 days, with symptoms grouped into three clusters and vaccination linked to a reduced risk of long-term symptoms, highlighting the complexity of post-acute COVID experiences.
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Bundled payments are increasingly used globally to move health care delivery in a value-based direction. However, evidence remains scant in key clinical areas. We evaluated bundled payments for maternity care in the Netherlands during the period 2016-18.

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Introduction: Older adults with acute functional decline may visit emergency departments (EDs) for medical support despite a lack of strict medical urgency. The introduction of transitional care teams (TCT) at the ED has shown promise in reducing avoidable admittances. However, the optimal composition and implementation of TCTs are still poorly defined.

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Article Synopsis
  • Opioid use for chronic non-malignant pain has increased in Europe, prompting a need to explore the beliefs and practices of general practitioners (GPs) and community pharmacists (CPs) regarding this issue.
  • Both GPs and CPs largely agree on the overuse of opioids and express concerns about their addictive potential; however, GPs feel more self-efficacious and see fewer benefits from opioids than CPs.
  • Despite recognizing the need to reduce opioid prescriptions, less than half of GPs and CPs actively implement recommended strategies, highlighting the need for better education and collaboration to enhance opioid-related care.
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Background: Proton Pump Inhibitors (PPI) are frequently prescribed. Long-term use is associated with side-effects and patients often lack a valid indication. Inappropriate PPI prescribing thus needs to be addressed.

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Objectives: To assess the reporting and methodological quality of early-life policy intervention papers that applied difference-in-differences (DiD) analysis.

Study Design: Systematic review.

Data Sources: Papers applying DiD of early-life policy interventions in high-income countries as identified by searching Medline, Embase and Scopus databases up to December, 2022.

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Aims: The 2021 European Society of Cardiology prevention guidelines recommend the use of (lifetime) risk prediction models to aid decisions regarding initiation of prevention. We aimed to update and systematically recalibrate the LIFEtime-perspective CardioVascular Disease (LIFE-CVD) model to four European risk regions for the estimation of lifetime CVD risk for apparently healthy individuals.

Methods And Results: The updated LIFE-CVD (i.

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Objectives: To evaluate the efficacy of topical miconazole or amorolfine compared to placebo for mild to moderately severe onychomycosis.

Design: Randomised, double-blind, placebo-controlled trial, with computer-generated treatment allocation at a 1:1:1 ratio.

Setting: Primary care, recruitment from February 2020 to August 2022.

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Background: Lifestyle changes, especially regarding diet quality and physical activity, are important in the management of type 2 diabetes (T2D). This mixed-methods study explores self-initiated lifestyle changes in patients with T2D who followed a periodic fasting-mimicking diet (FMD).

Methods: Quantitative data were obtained from the Fasting In diabetes Treatment trial (November 2018 to August 2021) in which 100 participants with T2D, using metformin only or no medication, were randomised to receive a monthly 5-day FMD for twelve months next to usual care, or usual care only.

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Background: In the Netherlands, population-based cancer screening programmes (CSPs) are organized aiming at cervical, breast and colorectal cancer. For a CSP to be effective, high participation rates are essential; however, there is an alarming downward trend, including wide regional variation in screening uptake. General practitioner (GP) involvement can have a stimulating effect on screening participation.

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Introduction: Diabetic foot ulcers are feared complications of diabetes mellitus (DM), requiring extensive treatment and hospital admissions, ultimately leading to amputation and increased mortality. Different factors contribute to the development of foot ulcers and related complications. Onychomycosis, being more prevalent in patients with diabetes, could be an important risk factor for developing ulcers and related infections.

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Restriction of dietary carbohydrates, fat and/or protein is often used to reduce body weight and/or treat (metabolic) diseases. Since diet is a key modulator of the human gut microbiome, which plays an important role in health and disease, this review aims to provide an overview of current knowledge of the effects of macronutrient-restricted diets on gut microbial composition and metabolites. A structured search strategy was performed in several databases.

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Article Synopsis
  • Community-acquired Pneumonia (CAP) guidelines usually recommend admitting patients with moderate-to-severe cases and treating them with intravenous antibiotics.
  • A study at Haga Teaching Hospital compared outcomes of patients with moderate-to-severe CAP treated with oral antibiotics versus those treated with intravenous antibiotics, using a cohort of 314 patients.
  • Results showed no significant differences in 30-day mortality, ICU admission, or readmission rates, but intravenous patients had a longer hospital stay by an average of 2.6 days, suggesting oral antibiotics could be a safe alternative for selected patients.
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Objective: To explore the perspective of cardiac patients regarding the timing and manner of delivering lifestyle advice following an acute cardiac event hospitalization.

Methods: Dutch cardiac patients who experienced a cardiac event hospitalization participated in a semi-structured interview (n = 14) or a cross-sectional survey study (n = 119).

Results: Our findings indicate that cardiac patients are receptive to lifestyle advice throughout the care trajectory.

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Aims/hypothesis: The aim of this study was to evaluate the impact on metabolic control of periodic use of a 5-day fasting-mimicking diet (FMD) programme as an adjunct to usual care in people with type 2 diabetes under regular primary care surveillance.

Methods: In this randomised, controlled, assessor-blinded trial, people with type 2 diabetes using metformin as the only glucose-lowering drug and/or diet for glycaemic control were randomised to receive 5-day cycles of an FMD monthly as an adjunct to regular care by their general practitioner or to receive regular care only. The primary outcomes were changes in glucose-lowering medication (as reflected by the medication effect score) and HbA levels after 12 months.

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