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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To assess the completeness of hospital discharge summaries and the efficiency of the discharge summary system in two urban teaching hospitals. ⋯ Considerable deficiencies in the completeness of the discharge summaries and the efficiency of the discharge summary system were found in the participating hospitals. Replication of this study in other settings is indicated, and strategies to improve the process should be pursued.