Is a salary option still taboo to GPs?
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The presence of a pacemaker or an implantable cardioverter-defibrillator was considered an absolute contraindication for a magnetic resonance imaging study until recently. The publication of numerous studies, albeit with small numbers of patients, has challenged this assumption. With no serious adverse effects detected, it is evident that more patients with these devices will undergo an MR study. While we feel that no patient with an implanted device should be denied a potentially beneficial exam, some caution is obviously prudent and planning the study will enhance the benefit that the patient will derive while minimizing the risks.
Between 1890 and 1945 the number of induced (criminal) abortions increased in Amsterdam; from 1945 up until the 1960s the number decreased slightly. In 1965 the number of induced abortions that took place in Amsterdam was estimated at more than 2000. Complications were frequent and included infections, septicaemia, damage caused by injected soap and sometimes air embolism. Women in Amsterdam often used primitive methods of contraception, but effective methods, such as condoms and diaphragms, were also used to some degree. Oral contraception was introduced in The Netherlands in 1962. Its use increased rapidly and consequently many doctors were confronted with problems surrounding contraception, including failures and abortion requests. After a television programme on abortion in 1967, requests for abortion surged. Hospitals set up multidisciplinary abortion committees to assess the requests, but soon it became evident that the women themselves were better able to judge whether they should undergo the procedure. Abortion clinics were established outside hospitals. Support from the feminist movement played a role after changes were already underway. The nationwide number of abortions increased to 21,000 in 1972 and to about 25,000 in the 1990s. The number remained stable, even among teenagers, because caregivers placed a great deal of emphasis on adequate contraception.
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