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Autism spectrum disorder has neither a distinct pathogenesis nor pharmaceutical treatment, yet evidence continues to mount demonstrating immune dysfunction and inflammation in specific brain regions of children diagnosed with the neurodevelopmental condition. Link naar het originele artikel
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Depression and Anxiety May Worsen Quality of Life, Lung Function of Patients with Pulmonary Sarcoidosis, Study Says
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Depression and anxiety may worsen the quality of life and lung function of patients with pulmonary sarcoidosis, a study has found. The findings of the study, “Psychological burden associated with worse clinical outcomes in sarcoidosis,” were published in the journal BMJ Open Respiratory Research. Statistics indicate that 18% to 66% of patients diagnosed with sarcoidosis experience depression, and approximately a third (31% to 33%) struggle with anxiety. These values are higher than in the general population. “In other chronic pulmonary illnesses, psychological symptoms are associated with lower health-related quality of life (HRQoL) independent of disease severity,” the researchers wrote. “Depressive symptoms have been correlated with lower HRQoL in patients with sarcoidosis; however, these studies have not evaluated the association while controlling for other factors such as disease severity.” “Patients with sarcoidosis requiring treatment have higher rates of depressive symptoms and worse quality of life compared with asymptomatic patients, suggesting those requiring treatment should be evaluated separately,” the researchers added. In the study, a team from Johns Hopkins University in Baltimore set out to investigate the possible link between the high prevalence of depression and anxiety and worse clinical outcomes in patients with pulmonary sarcoidosis requiring treatment. “We hypothesized that psychological symptoms would be associated with an increased odds of healthcare utilization, worse HRQoL, and worse pulmonary function,” the investigators wrote. The study involved a total of 112 adult patients (median age of 57 years) who had been diagnosed with pulmonary sarcoidosis, and were receiving treatment at the Johns Hopkins Sarcoidosis Clinic. The degree of anxiety, depression, healthcare utilization, and health-related quality of life were all evaluated through questionnaires that the participants were asked to complete. Survey findings revealed that 34% of the patients enrolled in the study had mild depression, and 20% had moderate-to-severe depression. In addition, a fourth (25%) of the participants had mild anxiety, and 12% had moderate-to-severe anxiety. Statistical analyses showed that patients who had moderate-to-severe depression or anxiety were more likely (8.87 times for those with depression, and 13.05 times for those with anxiety) to have visited the hospital’s emergency department in the last six months, and to have worse HRQoL, compared to those who had no symptoms of anxiety or depression. In addition, the investigators found that patients who had moderate-to-severe depression tended to have worse lung function, as reflected by a lower carbon monoxide diffusion capacity, or DLCO (which measures the amount of oxygen that is transferred from the lungs to the blood), than those who had no symptoms of depression. No clear associations were found between depressive or anxiety symptoms and the chances of hospitalization, or the scores of other parameters commonly used to evaluate lung function, including forced vital capacity and forced expiratory volume in one second. “Our study confirms previous findings of high rates of psychological symptoms among sarcoidosis patients,” the researchers wrote. “Given the burden of psychological symptoms in sarcoidosis, and its associations with clinical outcomes, screening and treating for depression and anxiety may be especially important” in order to reduce acute healthcare utilization by patients and to improve their quality of life. The researchers noted, however, that future studies are still needed to better understand the impact that depression and anxiety may have on clinical outcomes in patients with sarcoidosis. The post Depression and Anxiety May Worsen Quality of Life, Lung Function of Patients with Pulmonary Sarcoidosis, Study Says appeared first on Sarcoidosis News. Link naar het originele artikel -
Ik vroeg mezelf af wie er ervaring heeft met vasten. Laatst was er bij Dokter van Morgen een hele uitzending gewijd aan vasten en werd er uitgebreid ingegaan op reuma en de effecten van vasten hierop. Op Pubmed kon ik maar 1 onderzoek vinden specifiek voor sarcoidose maar de uitslag vind ik verbluffend. 85% van de deelnemers voelden zich beter; https://www.ncbi.nlm.nih.gov/pubmed/8744116/ Ik ben benieuwd naar jullie ervaringen.
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IBD prevalence three times higher than estimates and expected to rise, new study reveals
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The number of people suffering from inflammatory bowel diseases (IBD) is three times higher than previous estimates, with sufferers also at a higher risk of developing colorectal cancer (CRC), according to new research presented today at UEG Week Barcelona 2019. Link naar het originele artikel - Laatste week
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I haven’t felt like myself the past couple of days. One night, I drifted off at about 11 p.m. only to wake up around 2 in the morning. I wasn’t able to fall back asleep and didn’t want to disturb my wife, so I went downstairs. Last week, I attended the funeral of a family member who passed away because of a blood clot. She would’ve turned 43 the day after my daughter’s 20th birthday. The day before, I found out that one of my friends had lost her mother. The day before that, I discovered that a childhood friend was hospitalized due to diabetes complications. Everything happened so quickly that I started thinking about my own mortality. I couldn’t fall back asleep, so I continued on, through the motions of family life: shopping, cooking, running errands. I kept thinking about my friend in the hospital. I remembered all the times I was hospitalized for my spontaneous pneumothorax and how lonely it was. Hospitals can be alienating, especially when the only people visiting you are medical professionals who speak a language that’s far beyond your understanding. I considered texting or calling my friend to let him know that I was thinking about him. But the more I thought about it, the more it bothered me. Trust your gut and make a difference Later that day, I decided I would visit him. I arrived at the hospital and saw that his door was closed, so I knocked before entering. His room was dark and dreary. He was lying in bed watching an old episode of “Gunsmoke” when he looked up and saw me. He was pleasantly surprised that I came, and he smiled immediately. I hadn’t seen him in about three years. We talked and laughed and shared our medical issues. He said he was nervous about a procedure the doctors were considering, and I assured him that he would be fine. Being the animated storyteller that I am, I shared some of my hospital experiences and said, “If I can have both of my lungs collapse and still be able to laugh, you’ll be just fine!” We laughed so hard I had to grab my oxygen. Several doctors came to see him while I was there. I hadn’t realized that he was scheduled for the procedure he mentioned in about two hours. They were prepping him for surgery, so we wrapped up our visit. I think both of us were glad that we were able to see each other. I felt refreshed and was happy that I didn’t talk myself out of the visit. Sometimes sarcoidosis tries to hold us hostage, but we can’t let ourselves be victimized by this condition. Believe that you can make a difference, even when you least expect it. You are the difference. *** Note: Sarcoidosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Sarcoidosis News or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to sarcoidosis. The post I’m Glad I Made a Difference in My Friend’s Life appeared first on Sarcoidosis News. Link naar het originele artikel
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Chemical used in BPA-free plastics may play role in inflammation, obesity
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A compound used to reduce public exposure to possible toxic effects of the chemical Bisphenol A (BPA) may cause impairment to fat cells, which could lead to widespread inflammation and obesity. The first-of-its-kind study is published ahead of print in the American Journal of Physiology—Cell Physiology. Link naar het originele artikel -
Not all fats are equal in how they affect our skin, according to a new study in the Journal of Investigative Dermatology. The investigators found that different ketogenic diets impacted skin inflammation differently in psoriasiform-like skin inflammation in mice. Ketogenic diets heavy in medium-chain triglycerides (MCTs) such as coconut, especially in combination with omega-3 fatty acids from fish oil and plant sources like nuts and seeds, exacerbated psoriasis. Link naar het originele artikel
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Current treatments for dry eye disease do not work for everyone. A preliminary investigation of new antibody based eye drops produces encouraging results. Link naar het originele artikel
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Influenza B is one type of influenza virus that can cause the flu. It typically causes milder flu symptoms than influenza A and affects children more often than adults. Learn more here. Link naar het originele artikel
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At this time of year, a window opens for millions of people to find savings on their healthcare costs. Medicare’s annual open enrollment period, which runs from Oct. 15 to Dec. 7, allows you to review and make changes to your existing healthcare and prescription coverage. While it might seem a tedious and time-consuming task, living with a chronic illness such as sarcoidosis can be costly, and this open window can determine your healthcare costs for the next year. Letting savings slip away If you’ve let open enrollment periods slide by in the past without taking action, you’re not alone. More than 60 million people are covered under Medicare, and about 10,000 join the ranks each day. Just one in 10 of those who enrolled in Medicare Advantage plans with prescription medication coverage in 2013 voluntarily switched to another plan in 2014, according to the Kaiser Family Foundation. An average of 13 percent of Medicare Part D enrollees voluntarily changed plans during four enrollment periods between 2006 and 2010, even though doing so often results in lower out-of-pocket costs, a 2013 study by Kaiser found. Why 2020 plan coverages are worth a look It’s a good idea to carry out an annual review of your coverage and any proposed changes to it to see how it stacks up against other plans being offered, particularly if your health status or prescriptions have changed. The Centers for Medicare & Medicaid Services has also projected lower 2020 premium costs for both Medicare Advantage and Medicare Part D plans. Medicare Advantage average monthly premiums are expected to drop 14 percent to an estimated $23 in 2020, compared to an average of $26.87 in 2019. Enrollees will have an additional 1,200 Medicare Advantage plan options in 2020 than in 2018. If you’ve had your eye on an Apple Watch, The Verge reports that one private Medicare Advantage insurer is offering a significant discount to its members. Where to find free assistance You can search for plans using the recently redesigned Medicare Plan Finder and review your plan options here. And the national network of the State Health Insurance Assistance Programs provides free, unbiased, one-on-one counseling, and assistance. To find your local SHIP, click here. So what are you waiting for? Happy hunting! *** Note: Sarcoidosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Sarcoidosis News or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to sarcoidosis. The post Are You Missing Out on Ways to Cut Healthcare Costs? appeared first on Sarcoidosis News. Link naar het originele artikel
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Roos Striethouldt is gewijzigd
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The shingles vaccine is effective, but it can cause side effects. Learn about the possible mild, serious, and long term side effects here. Also, learn who may benefit the most from the vaccine and who should avoid it. Link naar het originele artikel
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FDA Grants Breakthrough Therapy Status to Ofev for Sarcoidosis, Other ILDs
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The U.S. Food and Drug Administration (FDA) has granted the designation of breakthrough therapy to Ofev (nintedanib) for the treatment of patients with sarcoidosis and other types of progressive fibrosing interstitial lung diseases (ILDs). The breakthrough designation is given to medications that provide significant advantages over currently available options. It is intended to accelerate the development, review, and approval of medications to treat serious or life-threatening conditions. ILDs comprise more than 200 disorders, including sarcoidosis and pulmonary fibrosis — a condition in which the lungs become irreversibly scarred and cease to work properly. Ofev is an approved anti-fibrotic therapy (a medication that reduces lung tissue scarring), marketed by Boehringer Ingelheim, for the treatment of idiopathic pulmonary fibrosis (IPF) and scleroderma. The medication works by interfering with the PDGF and FGF signaling pathways, known to be overly active in patients with lung fibrosis (scarring). The breakthrough designation for the treatment of progressive ILDs was granted based on findings from the Phase 3 INBUILD trial (NCT02999178). The study, sponsored by Boehringer Ingelheim, enrolled 663 adult patients with progressive ILDs other than IPF who were randomly assigned to receive either Ofev (administered at a dose of 150 mg twice a day) or a placebo for one year (52 weeks). The trial’s primary endpoint was to determine the annual rate of lung function decline by measuring changes from baseline to week 52 in patients’ forced vital capacity (FVC, the amount of air a patient is able to exhale after taking a deep breath). Secondary endpoints included assessing changes from baseline to week 52 in the participants’ health-related quality of life, as well as the time patients lived until showing signs of disease progression, experiencing an acute exacerbation or death. Findings from the INBUILD trial — recently presented at the European Respiratory Society (ERS) International Congress, and published in the New England Journal of Medicine — showed that it met its primary endpoint, with Ofev reducing patients’ lung function decline by 57% over the course of one year compared with the placebo. The most common adverse event seen during the trial was diarrhea, which was more frequent among patients treated with Ofev (66.9%) than among those treated with the placebo (23.9%). This finding was consistent with observations from previous studies. “We believe Ofev may help address an unmet medical need by providing a therapy for patients across a spectrum of ILDs with a progressive phenotype,” Thomas Seck, MD, senior vice president of medicine and regulatory affairs at Boehringer Ingelheim, said in a press release. “We are encouraged by this breakthrough therapy designation and look forward to working closely with the agency to offer this therapy to patients for which there are no FDA-approved treatment options,” Seck added. One of the expectations of experimental medications that receive the status of breakthrough therapy is that sponsors launch a compassionate use protocol to make the investigational treatment available to patients who may benefit from it. Boehringer Ingelheim has already launched a compassionate use program that allows those with progressive ILDs who are not eligible or unable to participate in clinical trials to have access to Ofev. According to Boehringer, the company has also submitted regulatory applications for Ofev to other regulatory bodies, including the European Medicines Agency. The post FDA Grants Breakthrough Therapy Status to Ofev for Sarcoidosis, Other ILDs appeared first on Sarcoidosis News. Link naar het originele artikel -
Alzheimer's disease: Brain immune cells may offer new treatment target
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A new study attributes the link between tau protein clumping and brain damage in Alzheimer's disease to brain immune cells called microglia. Link naar het originele artikel -
A striking proportion of psoriasis patients remain untreated with an average diagnosis time of five years, a new study has found. Link naar het originele artikel
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Researchers have found that blood vessels likely contribute to the development of inflammatory bowel diseases. The finding also suggests novel treatments. Link naar het originele artikel
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Protective mediators can help heal injured tendon cells by attacking inflammation
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Tendon tears, both to the rotator cuff and Achilles heel, are common injuries, especially in aged individuals. Painful and disabling, they can adversely impact quality of life. New approaches are required to help patients suffering from chronic tendon injuries. A novel study in The American Journal of Pathology identified mediators that promote resolution of inflammation as potential new therapeutics to push chronically injured tendons down an inflammation-resolving pathway. Link naar het originele artikel -
Nature Has Benefits That Help Me to Manage My Chronic Illness
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The other day, I took a 20-minute drive to a local lake. During the summer season, the location is crowded and busy, but after Labor Day, it’s quiet and tranquil. Now that fall has arrived, the scenery is beautiful as the leaves change their colors. I sat on a bench by the lake while enjoying the peaceful setting. Then I took a short walk near the water’s edge. I was uplifted by the calming sounds around me and ready to face the rest of my day having gained a new perspective. Finding serenity by the lake. (Photo by Kate Spencer) Research has long suggested a strong connection between time spent in nature and reduced stress, anxiety, and depression. I read an interesting article recently about a pilot project in Scotland that involves primary care doctors handing out “nature prescriptions” to their patients. I didn’t appreciate nature when I was younger. I wasn’t disrespectful or abusive toward wildlife. But aside from spending time on the beach as a teenager, the outdoors didn’t hold much interest for me. Since my sarcoidosis diagnosis, I have gained a new appreciation of the outdoors and nature. I’m drawn to quiet environments, and being in nature satisfies my need for serenity. The beach is still a favorite destination of mine. But now I prefer to go there during the off-season. I find it more relaxing once the crowds have gone home. And when the summer’s over, the seaside is more bearable without the heat-related challenges of sarcoidosis. Walking in the woods, along a canal, or near any form of water is therapeutic. On days when I don’t feel up to walking, a drive in a setting outside the city brings benefits. On other days, my garden and its visiting butterflies offer me solace. However, while I love spending time in nature, I face limitations imposed by the weather. Rain, snow, ice, and cold temperatures are real challenges here in the Northeast. For a while now, I have used a white noise machine at bedtime. The device has a choice of sounds: ocean, rainforest, or rainfall. I believe that it helps to drown out noises from inside the house and around the neighborhood while I sleep. But I’ve recently discovered the noise machine is also useful during the day when I’m unable to get outdoors. Although it can’t replace the physical experience of being outside, the calming sounds are an adequate substitute for the real thing. If you haven’t found your nature fix yet, you should try it. You might be pleasantly surprised by what you discover. *** Note: Sarcoidosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Sarcoidosis News or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to sarcoidosis. The post Nature Has Benefits That Help Me to Manage My Chronic Illness appeared first on Sarcoidosis News. Link naar het originele artikel -
Blood vessels offer new approaches for treating chronic inflammatory bowel diseases
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In Germany alone, there are around 400,000 patients who suffer from chronic inflammatory bowel diseases. For the first time, researchers at Universitätsklinikum Erlangen have discovered that dysfunctions in blood vessels play a significant role in the development of such diseases. In experimental model systems, the progression of the disease slowed down significantly by eliminating these dysfunctions. The researchers have now published their results in the Journal of Clinical Investigation. Link naar het originele artikel -
Are steroids used too much for patients with inflammatory bowel disease?
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Steroid therapy is commonly used to treat acute attacks of the inflammatory bowel diseases ulcerative colitis and Crohn's disease; however, because it does not provide long-term benefits and it carries a risk of serious side effects, it should not be used to treat inflammatory bowel disease for more than three months. Link naar het originele artikel -
I don’t cry often. So, one morning recently, as I stared out of the window at breakfast, I was surprised when tears started streaming down my face. I had been feeling worn out and overwhelmed for weeks, fearing that the life I’ve rebuilt would come crumbling down. I hadn’t felt like the warrior rejuvenated by a weekend getaway in a while. I struggled to go to my part-time job every day, returning home with nothing left to give. My to-do lists had turned into a stack of “I have no energy for that” notes. Sharing the burden Then, two weeks ago, within 24 hours of arriving from Florida, my younger brother, Antony, was running around helping me with whatever I needed. I had cried at the knowledge that this time he’s not just here visiting our family in Pennsylvania, he’s moved back to live. The realization that he’s here to stay has made the ongoing burden of my sarcoidosis feel much lighter. Pushing through with help My days with sarcoidosis are unpredictable. I never know how much pain, fatigue, brain fog, or other symptoms will be riding along on any given day. My health battles can make everything I need to accomplish feel like mountains rather than minor hurdles. Most days, I have a small window to tackle the necessities before sarcoidosis puts its foot down and says, “No more.” Life’s tasks can pile up and overwhelm me. When that happens, my younger brother never fails to bring me off my emotional cliff with three words: “I got you.” He has been an incredible support to me throughout my illness, even when he was living 1,100 miles away. A little goes a long way My family has been an integral part of my battle with sarcoidosis. But it’s the little things that they do outside of my healthcare that make me smile and carry me through the low points. My sister, whose eyes glaze over at the mention of football, gave me a mug bearing the logo of my favorite team, the New Orleans Saints. Her gesture warmed my heart because she recognized the logo, a fleur-de-lis, so I know that though I bore her with my football fandom, she listens to me. My niece, Nautica, returning from her senior class trip to Disney World, Orlando, surprised me with “Black Panther” comic books she’d bought for me. My mom accompanies me to the front door to see me off whenever I leave, whether I’m going out of town or up the street to the store. My dad leaves Wawa pumpkin spice muffins — seasonal products that sell out before I can buy them — on the breakfast table for me. Being able to laugh while enjoying the company of my younger brother, who is by my side instead of 1,100 miles away, make the toughest days much easier. *** Note: Sarcoidosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Sarcoidosis News or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to sarcoidosis. The post My Brother’s Move Home Has Lightened My Sarcoidosis Burden appeared first on Sarcoidosis News. Link naar het originele artikel
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Mycophenolate Mofetil May Be Effective as Alternative Sarcoidosis Treatment, Small Study Suggests
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Mycophenolate mofetil (MMF) significantly reduced disease symptoms in people with sarcoidosis, and helped to reduce their daily dose of corticosteroids, a small study suggests. The study, “Mycophenolate mofetil as an alternative treatment in sarcoidosis,” was published in the journal of Pulmonary Pharmacology & Therapeutics. Sarcoidosis is characterized by an over-reactive immune system leading to the formation of small clumps of inflammatory cells throughout the body called granulomas. Over time, these granulomas can become hardened or calcified, causing permanent damage. For chronic cases, corticosteroids, such as prednisone, help relieve the inflammation, reduce the formation of granulomas, and prevent or lessen damage to organs. However, the long-term use of corticosteroids can cause serious side effects. In these cases, patients can instead use alternative immunosuppressive agents known as steroids-sparing agents, such as methotrexate, azathioprine, pentoxifylline, or infliximab. MMF, sold under the brand name CellCept by Genentech, is an approved immunosuppressive medication to prevent organ rejection in transplant patients (of liver, kidneys, and heart). It works by blocking the proliferation of immune cells, specifically T-cells and B-cells, and the release of pro-inflammatory factors. Given its good safety profile and lack of lung toxicity, some sarcoidosis patients have been successfully treated with MMF as a corticosteroid-sparing agent when needed. In the absence of clear evidence demonstrating the effectiveness and safety of MMF in sarcoidosis patients, researchers conducted a small, systematic analysis of records of patients treated for sarcoidosis at the 2nd Respiratory Medicine Department of Medical School of the National and Kapodistrian University of Athens, in Greece. The researchers identified eight patients with biopsy-confirmed sarcoidosis who were treated with MMF for at least one year between 2008 and 2017. Response to MMF treatment was based on the sarcoidosis organ assessment tool by the World Association of Sarcoidosis and other Granulomatous Disorders, plus radiological imaging techniques using positron emission tomography or computed tomography. Changes in lung function were also assessed before and after MMF treatment. Lung function improvements were defined as an increase in forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) of 10% or more, and an increase of 15% or more in the diffusing capacity for carbon monoxide (DLCO), a measure of lung efficiency. Adverse events were also recorded. The results showed that sarcoidosis symptoms and chest imaging data improved in all patients. Cardiac and renal disease disappeared, while skin-associated sarcoidosis significantly improved. Significant improvements were seen in the average FEV1 (74.5% to 84.8% predicted), and FVC (86.2% to 92.4% predicted), as well as a trend of improvement in DLCO tests (68.8% to 81.1% predicted). Of note, higher percentages on these parameters indicate better lung function. Before MMF treatment, six patients were taking prednisolone. During the treatment period, the average daily dose of prednisolone was reduced from 15 mg to 2.5 mg. Regarding safety, all patients tolerated MMF well, except for one patient who developed diarrhea after four years of treatment. The diarrhea was resolved after MMF treatment was stopped. Overall, the analysis suggested that MMF administration safely and effectively improved sarcoidosis symptoms, and reduced the daily dose of corticosteroids. “This study indicates that MMF can be used as an effective corticosteroid sparing agent in patients with systemic sarcoidosis,” the researchers said. “Further randomized controlled studies are needed in order to evaluate the exact efficacy and safety of the use of MMF in patients with sarcoidosis,” they added. The post Mycophenolate Mofetil May Be Effective as Alternative Sarcoidosis Treatment, Small Study Suggests appeared first on Sarcoidosis News. Link naar het originele artikel -
Dry skin, pain, and itching... Atopic dermatitis affects the everyday lives of nearly 20% of children, and up to 5% of adults. The condition can have a significant impact on the quality of life of these patients. Link naar het originele artikel
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Crohn's disease study identifies genetic variant with potential to personalize treatment
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The largest study ever to look at why an expensive and commonly used group of drugs fails some patients with Crohn's disease has identified a genetic marker which could individualise drug treatment. Link naar het originele artikel -
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Teske Swinnen is gewijzigd
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De herkeuring van chronisch zieken gaat stoppen. https://nos.nl/l/2304688
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Heel verstandig, succes!