Our review shows that high-quality studies on the diagnosis of lactose malabsorption and intolerance in primary care are urgently needed. An important prerequisite would be to clearly define the concept of lactose intolerance, as well as how it should be assessed.

SUMMARY BackgroundDespite the trend towards making a positive diagnosis of irritable bowel syndrome (IBS), many health care providers approach IBS as a diagnosis of exclusion.

Although calprotectin and ultrasonography showed consistent and promising findings, none of the studies was performed in primary care. To assist primary care physicians in diagnostic decision making, we urgently need high quality studies performed in primary care.

In spite of the increasing number of women medical students, in many specialties the number of women actually working as doctors still lags behind the number of men working in the same profession. To define factors contributing to this discrepancy 646 medical students at the Vrije Universiteit in Amsterdam were surveyed. A questionnaire was used to obtain information about the difference between women and men medical students concerning their outlook on a future career as combined with domestic responsibilities. The questionnaire covered the items motives and career preference, barriers to reaching the profession of first choice, career planning and the combination of domestic responsibilities and a medical career. The results of this survey indicate that there are still important differences between women and men students in career perspectives. These differences need attention from medical students as well as teaching staff.

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Persons who somatise have an increased risk of becoming depressed or anxious in subsequent years, over and above baseline levels of depressive or anxiety symptoms. They may represent a target group for prevention of depressive and anxiety disorders.

Although the etiology of dizziness in older patients differs significantly from that of younger patients, most guidelines on dizziness advocate the same diagnosis-oriented approach for all patients regardless of their age. However, this diagnosis-oriented approach may be insufficient for older patients presenting with dizziness in general practice, because (1) general practitioners are often not able to identify an underlying cause of dizziness, (2) general practitioners regularly identify causes of dizziness that cannot be treated, and (3) general practitioners may identify causes of dizziness for which treatment is available but not desirable. In this article, the authors present a simultaneous diagnosis- and prognosis-oriented approach for older dizzy patients. This approach may enable general practitioners to improve their care for a voluminous group of impaired older patients, even if a diagnosis is not available (yet).

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