This article outlines the historical development of the principle of patients' free choice of doctor in the Netherlands. Far from being the result of debates on patients' rights, this principle was used instead as an instrument by the medical profession to gain a foothold in the power relations between doctors and sickness funds back in the early 20th-century. This development created a medical power bloc that lasted for most of that century and forced sickness funds and private insurers to start organizing in this fashion too. Therefore, when the new market ideology of introducing competition in health care was introduced in 1987, the fields of health provision and insurance were already defined by a high degree of cartelization. These relations lingered even after the introduction of regulated competition in 2006. Knowledge of this history therefore leads to a better understanding of current debates and problems in the organization of Dutch health care.
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Kidney Int
January 2025
Néphrologie et Dialyse, Centre Hospitalier Le Mans, 194 Avenue Rubillard, 72037 Le Mans, France.
Kidney replacement therapy (KRT) is one of the most energy-consuming and waste-producing medical treatments. Reducing the need of dialysis is therefore an environmentally friendly choice. However, preferring prevention, lifestyle-related interventions and patient education to drugs is time consuming and most physicians are already overburdened by the many demands of routine clinical practice.
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January 2025
University of Washington School of Medicine, Seattle, Washington, USA.
Introduction: The Society for Pediatric Anesthesia Quality and Safety Committee developed the Pediatric Regional Anesthesia Time-Out Checklist, consisting of 14 safety items intended to be reviewed by an anesthesia team prior to a regional anesthetic. Primarily, we hypothesized that use of this Checklist would increase the number of safety items performed compared with no checklist, evaluating the usefulness of this tool. Secondarily, we hypothesized that, after checklist training, subjects would show better clinical judgment by electing to perform a regional anesthetic in scenarios in which no programmed error existed and electing to not perform a regional anesthetic in scenarios in which a programmed error did exist.
View Article and Find Full Text PDFJ Clin Med
January 2025
Department of Vascular Surgery, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania.
: The autologous arteriovenous fistula (AVF) is the preferred choice for vascular access in patients with end-stage kidney disease (ESKD) undergoing maintenance hemodialysis. However, in the long term, the primary patency of AVF is suboptimal, with an AVF failure of approximately 30% in one year. The aim of this study is to examine how the pre-operative baseline levels of interleukin-6 (IL-6) affect long-term AVF failure.
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January 2025
Department of Hand and Plastic Surgery, Thurgau Hospital Group, 8501 Frauenfeld, Switzerland.
AI, especially ChatGPT, is impacting healthcare through applications in research, patient communication, and training. To our knowledge, this is the first study to examine ChatGPT-4's ability to analyze images of lower leg defects and assesses its understanding of complex case reports in comparison to the performance of board-certified surgeons and residents. We conducted a cross-sectional survey in Switzerland, Germany, and Austria, where 52 participants reviewed images depicting lower leg defects within fictitious patient profiles and selected the optimal reconstruction techniques.
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January 2025
Hepatogastroenterology Unit, 2nd Department of Internal Propaedeutic Medicine, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, 12462 Athens, Greece.
Irritable bowel syndrome (IBS) is a chronic disorder of the gastrointestinal tract. Its pathogenesis involves multiple factors, including visceral hypersensitivity and immune activation. NLRP3 inflammasome is part of the nucleotide-binding oligomerization domain-like receptor (NLR) family, a crucial component of the innate immune system.
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