[The dawn of a smoke-free leisure industry in The Nederlands]. / Aan de vooravond van een rookvrije horeca in Nederland.

From the 1st of July 2008 the Dutch smoking ban for public spaces will be extended to hotels, restaurants and bars. The ban is a result of a 2003 Health Council report in which it was concluded that the annual incidence of deaths due to passive smoking is considerable. Based on these numbers, smoking in public spaces is prohibited since 2004. In a society where smoking in public spaces is prohibited, the harm of passive smoking will decrease. In this issue of The Nederlands Tijdschrit voor Geneeskunde (Dutch Journal of Medicine) a number of articles are dedicated to the subject of smoking.

[Two-thirds of doctors are female, but ever still behind]. / Twee derde van de artsen vrouw, maar nog steeds op achterstand.

At present, two-thirds of the medical students in The Netherlands are women. However, the problems of combining a medical education with the responsibilities of motherhood, and the inaccessibility of medical top positions for women, are as serious as they were ten years ago at the 65th anniversary of the Dutch Association of Medical Women (VNVA). There is a serious need for medical education to become more 'woman-friendly'--and 'man-friendly' for that matter. For healthcare workers, it should be feasible to combine having children with a career. In addition, research into gender-specific health differences should be facilitated. Women, in particular, should take their responsibility in this respect, and be aware of the achievements of their pioneering predecessors. Last but not least: the Dutch Journal of Medicine needs to adapt. It needs to address a new audience, in which the male readers aged 50 and over have been largely replaced by female physicians in their thirties with children.

[Hippocrates in the age of reality television]. / Hippocrates in het tijdperk van de 'reality-tv'.

At the end of their studies, physicians take the Hippocratic Oath. Medical and societal changes have meant that the oath has been altered over time. The oath still stipulates that the privacy of the patient should be respected. These days there is increased pressure on physicians and institutions to breach the duty of professional confidentiality. However, physicians themselves should also consider being more careful when talking about their patients outside the consulting room. They should definitely be aware oftheir responsibilities when participating in a reality series on television. In addition, medical information that is disclosed on Internet videos may negatively affect patients and physicians. Medical openness is commendable, but negligence may lead to loss of respect.

WITHDRAWN: Drugs for treating giardiasis.

BACKGROUND: There can be a high rate of recurrence of disease after initial drug treatment for giardiasis. These drugs also have a range of adverse effects. OBJECTIVES: The objective of this review was to assess the effects of drug treatments for giardiasis. SEARCH STRATEGY: We searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL, MEDLINE, EMBASE, Current Contents, and reference lists of articles. SELECTION CRITERIA: Randomised and quasi-randomised trials of drug therapy for giardiasis compared with placebo or another drug. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trial quality and extracted data. MAIN RESULTS: Thirty-four trials were included. Only one trial was without serious methodological flaws. Compared with placebo, drug treatment was associated with an improved cure rate (odds ratio 11.51, 95% confidence interval 2.29 to 57.98). Metronidazole treatment longer than three days had a better parasitological cure rate than other long treatment courses (odds ratio 2.41, 95% confidence interval 1.31 to 4.44), but there was significant heterogeneity between the trials. Available evidence has not detected a difference in cure between single dose therapy and longer treatment courses (odds ratio 0.33, 95% confidence interval 0.08 to 1.34). Within the single dose regimens, the available evidence did not demonstrate a difference in parasitological cure rate between tinidazole and other short therapies (odds ratio 3.39, 95% confidence interval 0.95 to 12.04), but had a higher clinical cure rate (odds ratio 5.33, 95% 2.66 to 10.67). AUTHORS' CONCLUSIONS: A single dose of tinidazole appears to give the highest clinical cure rate for giardiasis with relatively few adverse effects.

[Power in the consulting room]. / Macht in de spreekkamer.

Three physicians reflect on the theme 'power in the consulting room', but in fact they are mostly discussing disempowerment. In this article we discuss strategies involved in the physician's power over patients and factors that limit these powers.

[A series about the value of physical examination]. / Een serie over de waarde van lichamelijk onderzoek.

This article is the introduction to a new series in the Nederlands Tijdschrift voor Geneeskunde about the value of physical examination. Associated with this series, on the website (www.ntvg.nl) there are chapters of the new textbook on physical examination and films about carrying out physical examinations. Although physical examination is an essential part of the diagnostic process, often little attention is paid to the correct execution of the examination and there is insufficient knowledge of the value of the findings. The diagnostic process usually involves analysing all the information from the patient's history and a physical examination. However, research has only been done on the value of specific tests and even that is very limited. The most important measure we use for the results of a physical examination is the likelihood ratio, which shows how the likelihood of presence or absence of a disease changes depending on the examination results.