[A farewell to Van Gijn]. / Bij het afscheid van van Gijn.

Prof. Dr. J. van Gijn has stepped down as editor-in-chief of the Nederlands Tijdschrift voor Geneeskunde (Dutch Journal of Medicine), a position he has held for twelve years (1996-2007). The journal has greatly benefited from his scientific expertise and medical authority. In his detailed scrutiny of every submitted article, he adopted the position of a 'general clinical reader', wishing to look over the fence of his or her specialty and to learn about the developments in other medical areas. An editor of several major neurological journals, he introduced new sections, e.g. 'Diagnostic image' and 'Dutch research in foreign journals'. An important decision was to strengthen the didactic qualities of the journal, among other things by enhancing the journal's illustrations. His amiable way of dealing with authors, peer reviewers, his coeditors and the editorial staff, as well as his sense of humour, have left a lasting impression.

[The Nobel Prize in Physiology or Medicine 2007 for the development of 'knockout' technology]. / Nobelprijs Fysiologie of Geneeskunde 2007 voor de ontwikkeling van de 'knock-out'-technologie.

The Nobel Prize in Physiology or Medicine 2007 has been awarded to Mario R. Capecchi (University ofUtah, Salt Lake City, USA), O. Smithies (University of North Carolina, Chapel Hill, USA), and Sir Martin J. Evans (Cardiff University, Cardiff, UK) 'for their discoveries of principles for introducing specific gene modifications in mice by the use of embryonic stem cells'. Transgenic mice are often used to study the function of a single gene. The Nobel Prize winners succeeded in silencing the targeted gene in an embryonic stem cell. They went on to introduce it into a blastocyst and then implanted it in a surrogate mother mouse. The blastocyst grew into a genetically modified mouse, better known as a 'knockout' mouse.

[The founding of the 'Vereeniging Nederlandsch Tijdschrift voor Geneeskunde' [Society of the Dutch Journal of Medicine] on 28 September 1856]. / De oprichting van de 'Vereeniging' Nederlandsch Tijdschrift voor Geneeskunde op 28 september 1856.

On Sunday the 28th of September 1856, 150 years ago this year, a meeting was held in Amsterdam at which the 'Nederlandsch Tijdschrift voor Geneeskunde' [Dutch Journal of Medicine] was founded. There are strikingly few sources of information on this happening. The 150th volume of the Journal is appearing this year. In view of the coming anniversary, some old documents that had been laid aside at the time of the move from the Jan Luykenstraat to the Johannes Vermeerstraat in 1992 were re-examined. In a bundle of bound meeting reports from the early years, hidden in a folder inserted into the front cover, we found a printed 'Provisional rules and regulations'; the founding date of 28 September is given in these bylaws. These 'Provisional rules and regulations' also contain some handwritten remarks in the handwriting of J. Zeeman, the Chief Editor during the period 1867-1883. For example, he crossed out the provision that the Journal would be published 'at the expense of the editors' and changed this to 'by a society of editors'. This document provides insight into the introduction of the Society of Editors that still publishes the Journal to this day.

[Diseases and the diseased--scientific and alternative medicine]. / Over ziekten en zieken--wetenschappelijke en alternatieve geneeskunde.

Exposing alternative medicine as quackery and unscientific is necessary, but one should be aware of the limitations of scientific medicine as far as the care of individual patients is concerned. Medicine is primarily about people, not about science. Current regular medicine uses a rational approach and carries out actions of which the effectiveness has been demonstrated in controlled trials. But some questions cannot be translated into a testable hypothesis, e.g., what is the best treatment for the individual incurable cancer patient sitting in my surgery right now? However, this question is a relevant one, especially for the patient involved. In daily clinical practice, there is no clear distinction between scientifically-based and not-scientifically-based acts. The task of medicine is to cure, but also to encourage and to console. When exposing alternative medicine, one should be able to offer the patient a different approach; otherwise the exposure is nothing more than a nihilistic exercise. Alternative medicine does not cure diseases, but it sometimes helps diseased people.

[Diagnosis: not more than an agreement on disease entity]. / Diagnose: niet meer dan afspraak over ziekte-entiteit.

Once a hereditary disorder has been linked to a gene mutation, it is not uncommon to observe that patients with the mutation have a wider range of clinical features than was previously anticipated. This is the case with Friedreich's syndrome, of which the characteristic signs used to be progressive cerebellar ataxia and areflexia, with onset at an early age. Now that the causative mutation has been established, it also appears to be expressed as an 'atypical' disease, with a later onset, piramidal signs at an early stage, and retained tendon jerks. Diseases are defined according to a variety of criteria: cause, (patho)morphological findings, (patho)physiological changes observed by physicians, or subjective impressions by patients. The growth of biomedical knowledge often leads to diseases being redefined. Diseases are not independent entities but human constructions.

[Citing electronic sources in scientific articles]. / Verwijzing naar digitale bronnen in wetenschappelijke artikelen.

In 1995 a reference to an electronic source of information first appeared in this journal. Such sources are neither permanently available nor unchangeable. Both qualities are of central importance to the progress of scientific knowledge. Readers must have the opportunity to check the information referred to in scientific publications. It is scientifically useless to refer to a source that readers may not be able to find or where they find something else than the authors did when they wrote their article. However, electronic media, volatile as they may be, can be a very useful means of alerting readers to medical scientific developments. Therefore the editors of this journal have chosen to accept references to electronic information by way of a 'written communication' in parentheses in the text, until electronic scientific information is stored in an unalterable and generally accessible permanent form. The list of references at the end of scientific articles will be reserved to generally available paper and CD-ROM sources.

['Caring always'; physicians' expression of condolences to the relatives of patients]. / 'Troosten: altijd'; condoleancebetuigingen van artsen aan de nabestaanden van hun patiënten.

According to the WHO definition, palliative care does not end with the death of the patient, but also includes supporting the family members in dealing with the loss. A recent article refers to the importance of physicians writing letters of condolences. The letter of condolences marks the end of the treatment relationship. Writing such a letter can assist the physician in distancing him/herself from the death of his/her patient, and the letter can also help the family adjust to life without the deceased patient. The letter can also remove any distrust that may exist towards the medical profession. Reasons for not writing a letter of condolences include an own feeling of failure, administrative difficulties, indifference or incapacity. Nevertheless, writing a letter of condolences is an integral part of the care provided by the physician to the patient and his/her relatives.

[Significance of letters published in the Dutch Journal of Medicine, 1997/98]. / De betekenis van ingezonden brieven in het Nederlands Tijdschrift voor Geneeskunde, 1997/'98.

OBJECTIVE: To determine whether in the correspondence section of the Nederlands Tijdschrift voor Geneeskunde (Dutch Journal of Medicine, NTvG) serious criticism is formulated or important mistakes in the original articles are pointed out. DESIGN: Descriptive, retrospective bibliometric study. METHOD: Correspondence in the period July 5, 1997-June 27, 1998 published in the NTvG (n = 196 letters) was scored for 10 items and categorized in categories: 'agree', 'do not agree' (criticizing methods or results or interpretation, or unmotivated criticism) and 'political reaction'. The questions were studied to what category of published articles the letters referred and how many letters referred to the same articles. 22 letters from the period October-December 1998 were judged separately as the peer review reports of the original articles were still available. RESULTS: In 115 (58.7%) letters the writers expressed agreement with the original article. Almost 40% (77) of the 196 letters contained scientific discussion on the subject in question. Most reactions concerned 'Original articles' (25%) and 'Clinical lessons' (19.4%). In 8/196 (4.1%) a mistake was revealed; 6 of these reactions led to the publication of a 'Correction' (to 3 articles). There was no criticism which would have led to rejection of the article involved had it been known before publication. The letters about articles of which the peer reviews were still available contained no criticism of points the peer reviewers had missed. CONCLUSION: Of the correspondence letters of the NTvG 4.1% contained scientific criticism which could have led to changes in the article if it had been known before publication.

[Terminologia anatomica: a new reference work for anatomy]. / Terminologia anatomica: een nieuw anatomisch referentiewerk.

The Nomina anatomica (6th edition in 1989) was the standard anatomical nomenclature until recently. It has been succeeded by the Terminologia anatomica (TA) by resolution of the International Federation of Associations of Anatomists in 1999. By now the TA has been published as a book and on cd-rom. The objective of the TA is to further uniformize the anatomical terminology, also internationally, and especially to democratize it, i.e. to ensure that it accommodates the needs of clinicians and medical scientists. The number of anatomical terms listed has grown to more than 7500. The increase is caused mainly by the insertion of clinical anatomical and neuro-anatomical names. A number of incorrect or misleading terms have been replaced. Each Latin term has a unique code number and is supplied with an English equivalent (International anatomical terminology; IAT) the spelling of which in either UK English or American English is considered equally correct. Based on the TA every language can formulate its own anatomical nomenclature. The nomenclature is presented per system or organ tract. An alphabetic index follows TA as well as the English IAT list. The use of eponyms is discouraged, but a list of well-known ones is appended to facilitate accessibility of older literature. Relevant suggestions about amendments are eagerly awaited and a broad basis of endorsement among the medical scientific world is hoped for. This journal will adopt the TA/IAT from now on as the work of reference regarding anatomical terms.

[Duplicate publication of articles in the Dutch Journal of Medicine in 1996]. / Dubbelpublicaties in het Nederlands Tijdschrift voor Geneeskunde in 1996.

OBJECTIVE: To determine the number of undisclosed/disclosed duplicate publications of original articles (OA) in the Nederlands Tijdschrift voor Geneeskunde (NTvG). DESIGN: Retrospective bibliometric study. METHOD: All biomedical articles published in January 1994-June 1998 and written by the first or second author of the 148 OA published in 1996, were compared with the articles in the NTvG at the editorial office of the NTvG. Resemblances in the objective, study design, study population between the different articles were observed. The researchers assessed whether the same article had been published twice or more and whether this was acceptable or redundant (according to the criteria of the International Committee of Medical Journal Editors). RESULTS: In 1996 the NTvG published 30 (20%) OA which were also published elsewhere. In 23 cases (77%) the article was first published in another scientific journal and in 7 cases (23%) the article was published once again after its appearance in the NTvG. In 20 duplicate articles in the NTvG a footnote with a reference to the first publication was present. In 10 duplicate articles no such footnote could be found. In comparison with a similar study of the years 1990-1992 the number of duplicate publications was the same but the fraction of correctly disclosed duplicate publications had risen from 5/23 (22%) to 16/22 (73%) (p < 0.001).

[Effects of articles published in the Dutch Journal of Medicine]. / Effecten van artikelen gepubliceerd in het Nederlands Tijdschrift voor Geneeskunde.

OBJECTIVE: To inventory the effects of publishing in the NTvG. DESIGN: Retrospective, descriptive. METHODS: The first authors of the articles of the sections Clinical lessons, Capita selecta, For practice, Original articles, Case reports and Side effects of drugs, from the issues 27-53 of Volume 138 (1994) of the NTvG were approached for a written enquiry about the effects of their articles. Reactions in the form of letters to the editor were assessed by screening the relevant section. RESULTS: The results of the enquiry concerned 165 articles. The authors of 160 articles (97%) reported that they had been approached in person with reference to the publication, on average 15.7 times orally and 2.0 times in writing. The authors of 66 articles (40%) were invited to deliver a lecture, data from 62 articles (38%) were used by others and 54 articles (33%) resulted in (continuation) research. An approach by the media followed after 23 articles (14%). A positive effect on the number of relevant patient referrals was mentioned of 4 (44%) articles from section For practice and 7 (30%) articles from section Clinical lessons. Various other effects were reported of 48 articles (29%). Forty (20%) of the total of 197 articles involved in the study were followed by one or two letters to the editor, prompted mostly by Clinical lessons (33%). CONCLUSION: Virtually all articles produced an effect. Many articles were followed by personal reactions and many articles elicited a response indicating influence on medical teaching, science or clinical activity.

[Influence of specific clinical lessons in the Dutch Journal of Medicine on clinical management]. / Invloed van enkele klinische lessen in het Nederlands Tijdschrift voor Geneeskunde op het klinisch handelen.

OBJECTIVE: To establish whether publication of an article propagating a laboratory test leads to measurable increase of the number of requests for that test. DESIGN: Retrospective. METHOD: From volume 138 (1994) of the Dutch Journal of Medicine (NTvG), three clinical lessons were selected that contained an unequivocal clinical message and a recommendation to request a specific laboratory test for particular patients. All laboratories performing the test in question were asked to report the number of requests per month in the months before, after and during publication of the article in question and during the same months of 1993. The difference between the number of requests in the period after publication of the article in 1994 and in the same period in 1993 was determined and tested postulating a Poisson distribution. RESULTS: Regarding two clinical lessons (one about determination of Coxsackie virus in neonates and one about examining arthritis patients for parvovirus B19) no significant difference in the numbers of requests before and after the publication was found, particularly also because the laboratories could not supply itemized data so that relevant information was lost in a flood of other data. The third clinical lesson (about determination of antibodies against Onchocerca in patients complaining of itching after a trip to the tropics) was followed by a significant increase of the number of requests (from 50 to 90; p < 0.001) in the 3 months following publication. CONCLUSION: Publication of a clinical lesson about a recommended laboratory test for onchocerciasis in the NTvG resulted in a significant rise of the number of requests for that test.

What are the factors determining authorship and the order of the authors' names? A study among authors of the Nederlands Tijdschrift voor Geneeskunde (Dutch Journal of Medicine).

CONTEXT: Although criteria justifying authorship of scientific medical articles have been formulated, it is not well known how authorship is established in practice. OBJECTIVES: To assess the criteria for authorship used by authors of original articles in Nederlands Tijdschrift voor Geneeskunde (NTVG, the Dutch Journal of Medicine), and to determine whether the criteria for authorship of the International Committee of Medical Journal Editors (ICMJE) are known and applied. DESIGN: Survey questionnaire. SETTING: Editorial office of the NTVG. PARTICIPANTS: All 450 authors of 115 original articles published in 1995. MAIN OUTCOME MEASURES: Author's contribution to study design, material, collection of data, statistics, and writing. RESULTS: Of 362 forms returned, 352 could be analyzed (78.2% response rate). The 5 questions most frequently answered affirmatively were ICMJE criteria: critical reading (86.1 % of the authors), approval of the final version (84.7%), study design (74.7%), study conception (64.2%), and revision (63.4%). Authors rated their contribution 2 points higher than did their coauthors. Interestingly, 64% of the respondents met the ICMJE criteria, although 60% of the respondents did not know them. CONCLUSION: Authorship was mostly in accordance with ICMJE criteria although many authors were not familiar with them.

[Editing of articles accepted for publication by the Nederlands Tijdschrift voor Geneeskunde]. / Redactionele bewerking van voor publicatie aanvaarde artikelen bij het Nederlands Tijdschrift voor Geneeskunde.

The Nederlands Tijdschrift voor Geneeskunde has been publishing medical science in Dutch for 140 years. To bridge the gap between the specialist science and the general medical reader several sections in the accepted papers have to be clarified, simplified and shortened by post acceptance editing. The style and language of the authors is treated with respect. Changes are made if the article does not comply with internationally accepted rules on scientific reporting, if the article can not be understood using currently authoritative general and medical books of reference, and if its language does not comply with generally accepted Dutch rules for grammar and spelling.

[Medical science in the Dutch language]. / Medische wetenschap in het Nederlands.

Medical researchers consider a publication in English to be of a higher standard than one in a local language such as Dutch. An international publication in English is appropriate when the readers addressed belong to an international scientific community, but the mere fact that a publication is in English is no indication of its importance. Research of a national scope and of national consequences should be published in the national native language. In addition the use of the mother tongue allows deeper and more balanced thought in comparison to the use of a second language. The application of study results in clinical practice in the Netherlands is enhanced by their publication in Dutch, as is the national recognition of the research group. Finally, articles in Dutch provide all of the Dutch clinicians with the opportunity to read original scientific work and not via a (popular) translation. This contributes to science-based clinical medicine in the Netherlands.