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Editorial: ‘Ah you love your work’

‘Ah you love your work’

Although we learned a lot, some habits never change. One of those habits is deadlines and the other one is working during holidays. While enjoying the sun in Florence, I am trying to write our editorial, an old Italian man passes by and says something in Italian to me. I reply in English and the man looks surprised and asks me, in his best English, whether I am on a work visit. No I am not, I am on a holiday. He laughs ‘ah you love your work’. He is, like most (truly) old people, right. Every edition we have deadlines and an amazing editorial board that, from time to time, forgets those deadlines but somehow do not mind to catch up during their holidays. With a team of over 50 people, from different generations and disciplines, there is one thing that connects us and that is the motivation that once got us on board. Mentioning this makes us obligated to express our gratitude towards our leaving members, who worked so incredibly hard in establishing this journal.

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Solving Statistics: Should I correct for multiple testing and what is the Bonferroni correction?

Should I correct for multiple testing and what is the Bonferroni correction?

Background

A hypothesis test is a method of statistical inference on sets of random variables, such as Hand Eczema Severity Index (HECSI) scores obtained from patients with hand eczema following treatment with hand creams “handy help” or “silky smooth”. If the values of the HECSI are normally distributed, a researcher can use Student’s t-test to compare the mean HECSI scores in both groups. The null hypothesis is that the mean scores are equal in both groups and the alternative hypothesis that the mean scores are not equal.

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Clinical Image: A 65-year-old female with an unusual object

A 65-year-old female with an unusual object

[headline_subtitle subtitle=”Can you come up with the proper diagnosis?”]
Presentation

A 65-year-old woman was presented with an unusual object sticking out of her chest. The patient has no pain, dyspnoe or fever. Her medical history included a mitral and tricuspid valve repair 15 years ago. Six months ago, a central venous catheter was placed for dialysis.

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Radiology Image: A 29-year-old male

A 29-year-old male

[headline_subtitle title=”” subtitle=”Can you solve the radiology image of this edition?”]
Patient data
  • Age: 29
  • Gender: Male
  • Medical history: None
  • Initial presentation: Dyspnoea, pain in right side of chest, saturation 80%, bulging neck veins, no breath sounds at the right side of chest, right side of the chest more convex.
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Interview: prof. dr. T. de Vries

prof. dr. T. de Vries

I was trained as a medical doctor at the University of Groningen. This was also the place where I was trained in general practice and clinical pharmacology (PhD) and was appointed as lecturer in clinical pharmacology in 1980, later combined with work in general practice. In 1996 I accepted a professorship in Pharmacology and Pharmacotherapy at the department of Medical Pharmacology at the VU University Medical Centre in Amsterdam.

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Subject 101: Delirium

Delirium

Delirium is a neuropsychiatric disorder that frequently occurs in a hospitalized setting. Despite this, it is often misdiagnosed or not recognized and as a result not treated properly which could have serious consequences for a patient’s health. Due to this fact, I would like to dedicate this Subject 101 to delirium by presenting an overview of the essence of this acute confusional state.

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Trial and Error: The young female intern – Clarify your role

The young female intern – Clarify your role

“Nurse, can you help me sit up?”, “Nurse, I would like to pee.”, “Thank you, nurse”. These are sentences I, as a female doctor in training, heard frequently from patients during my internship at internal medicine. I visited the patients that were addressed to me daily, never correcting patients because the mix up did not really bother me. At the end of one day a nurse came to me and said that a patient had complained that although there was a very friendly nurse, the doctor never visited him. He was almost at the point to make an official complaint about this. I was sure I visited this patient that day, but because I had not corrected the patient in his “thank you, nurse” he never knew I was the doctor (or in this case: the medical student).

As a young female intern it is always possible that a (often elderly) patient addresses you as nurse. In their beliefs, by experience, cultural background or because it has always been that way, a female is a nurse and a male a doctor (of course this is somewhat exaggerated). I never felt annoyed nor offended when a patient called me nurse, but I also did not correct them. Moreover, I never requested a nurse to help explaining that I was not the nurse but a medical student.

Following the experience with the unsatisfied patient about the medical attention he presumably had not gotten, I now always make clear I am a doctor-in-training. This is not just to avoid complaints, but it can be reassuring for patients to know that the doctor is giving them the attention they need.

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Changing Perspectives: Capnography

Capnography

On November 27th 1972, the Dutch medical society was shocked by the oration speech by dr. Bob Smalhout, an anaesthesiologist, entitled “De dood op tafel” (English “death on the table”). In this public lecture, he opened up about perioperative complications and deaths due to anaesthesia related errors. He made a plea to make anaesthesia related healthcare safer: he suggested necessitating adequate airway monitoring of patients during an operation.

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