Nederlands tijdschrift voor geneeskunde
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New biomedical technologies make it possible to replace parts of the human body or to substitute its functions. Examples include artificial joints, eye lenses and arterial stents. Newer technologies use electronics and software, for example in brain-computer interfaces such as retinal implants and the exoskeleton MindWalker. ⋯ Second, because in western thought the human mind, and not the body, is considered to be the seat of personhood. However, it has been argued by phenomenological philosophers that the body is more than just an object but is also a subject, important for human identity. From this perspective, we can appreciate that a bionic body does not make one less human, but it does influence the experience of being human.
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A 47-year-old man presented to the emergency department with a rapidly progressive, generalized rash and pustulosis shortly after he had started amoxicillin/clavulanic acid for the treatment of a pulmonary infection. Based on the patient's history and the clinical symptoms, the diagnosis of 'acute generalized exanthematous pustulosis' (AGEP) was suspected. This was confirmed by histopathological examination. The skin abnormalities slowly disappeared after terminating antibiotic medication.
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Ned Tijdschr Geneeskd · Jan 2013
[Concerns about residents' mental fitness: two possible strategies for a solution].
A good level of physical and mental fitness is essential in order to function optimally as a resident. Concerns about residents' mental fitness have recently been raised, based on high percentages of residents suffering from burnout and depression and data on the experience of stress and anxiety. ⋯ Finding solutions for the lack of, or deterioration in, mental fitness is crucial. We discuss two potential strategies: (1) the removal or reduction of obstacles to residents' mental fitness and (2) the provision of resources to improve mental fitness.
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Massive investments are being made for research into the prevention and reduction of risks and diseases. False-positive outcomes from screening investigations result in fear in a substantial number of patients, and are expensive for society as a whole. ⋯ The incidence of false-positive results of colorectal cancer screening is underestimated. The risks of overdiagnosis and overtreatment as a result of screening are substantial.
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If an intensive care unit (ICU) is managed by intensivists, the prognosis of critically ill patients improves. Some retrospective analyses of patient databases suggest that critically ill patients admitted to the ICU during off-hours suffer a higher mortality rate compared to patients admitted during office hours. While this suggests that this difference might be related to the presence/absence of experienced intensivists at night, differences in case mix of patients admitted during the day/night may play an important role. ⋯ Alternating every 7 nights an intensivist was present in the hospital or was available for consultation by telephone. No effect on ICU-length of stay, mortality or any of the secondary end points was found. Despite the compelling face value of nighttime intensivist staffing this practice should not be recommended in the absence of experimental evidence of its effectiveness.