Nederlands tijdschrift voor geneeskunde
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What is preferable for a patient who has requested euthanasia: self-administration of a lethal drink (assisted dying), or to have a drug administered intravenously (euthanasia)? We analysed data from a total of 226 patients who had been helped with assisted dying. In 86% of the cases (195 patients) death occurred within 30 minutes. ⋯ On the grounds of our analysis and these considerations, our preference is for assisted dying, subject to medical contra-indications. We expect that, with this knowledge, more doctors will be able to help with assisted dying.
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Ned Tijdschr Geneeskd · Aug 2018
Case Reports[A man with thoracic pain after visiting the tropics].
A 25-year-old man presented to the Emergency Department with thoracic pain and coughing after travelling through South America. Radiologic work-up revealed diffuse multifocal consolidations surrounded by a ground-glass halo and thoracic lymphadenopathy. A urine antigen test was positive for Histoplasma capsulatum, a fungus that is endemic in South America and which causes a severe pulmonary infection in 5% of the infected patients.
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Studying the pre-clinical foundations of the medical profession sharpens the mind, improves critical thinking skills, builds academic stamina, and stimulates scientific curiosity. However, incorporation of the ever-growing clinical knowledge body into medical curricula jeopardizes the time undergraduate medical students are exposed to covering the basic sciences. ⋯ Inasmuch as mastering basic sciences demands a substantial time consuming intellectual effort, medical students prefer memorization and reproduction tasks to analysing challenging basic science questions. These three factors increase the risk of training (future) generations of doctors less well equipped to manage complex patients and lacking the essential knowledge and academic inquisitiveness to advance health care and medicine.
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Ned Tijdschr Geneeskd · Aug 2018
Case Reports[A step-up approach for dealing with rectal foreign bodies].
Patients visiting a hospital with retained rectal foreign bodies can no longer be considered rare and the incidence appears to increase. Currently, little is known about management of patients with retained foreign bodies and there are no medical protocols for situations like this. ⋯ Standardised algorithms for patients with retained foreign bodies are needed to avoid serious complications such as perforation or peritonitis. In this article, we present a 59-year-old, 57-year-old and 29-year-old male who visited the emergency department with inserted rectal foreign bodies and we propose a stepwise approach for dealing with retained rectal foreign bodies.