CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
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Anne Mullens used a recent fellowship provided by the Atkinson Foundation to take an in-depth look at euthanasia in the Netherlands. During her time in Holland, she discussed the issue with doctors who support and oppose euthanasia. ⋯ She visited a hospital in Amsterdam that has received requests from foreigners seeking euthansia. Mullens offers a comprehensive look at an issue that continues to provoke strong feelings among Canadian physicians and patients.
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Multicenter Study
Diagnostic accuracy and short-term surgical outcomes in cases of suspected acute appendicitis.
To test the hypothesis that, with modern diagnostic methods and antibiotics, more conservative use of surgery in cases of suspected appendicitis would not result in increased rates of short-term complications in confirmed cases. ⋯ A higher diagnostic accuracy rate is associated with more perforated appendixes. Although perforation itself leads to adverse outcomes, a higher accuracy rate does not. This suggests that hospitals with higher accuracy rates incur more perforations, but, with close observation, timely laparotomy and the use of modern antibiotics, these patients have favourable outcomes. This contrasts with adverse effects of perforation among patients at high risk for perforation (especially very young children and elderly people) in centres at all accuracy levels. The variation in hospitals' diagnostic accuracy rates suggests that some proportion of appendectomies could be safely avoided.
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Most physicians see disabilities only in the patients they treat, but some doctors speak from personal experience when they say disabilities should not be a barrier to practising medicine. Neurologist Gordon Robinson of Vancouver says the spinal problems that left him a paraplegic could not stop him from practising. ⋯ He could still see patients in the office much as he had before simply by using an examining table that could be lowered. However, it may be more difficult convincing colleagues that physical disabilities are not an insurmountable barrier.