![]()
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Of mice and (no) men?Some insects and reptiles can
reproduce via parthogenesis: the unfertilized egg retains two sets of
chromosomes and begins to develop as if it had been fertilized. In mammals,
though, successful parthenogenesis has been regarded as virtually impossible.
However, a recent report from a group of Japanese scientists
has shaken that belief. The first parthenogenesis pup, ‘Kaguya’,
grew to be a healthy adult female mouse able to reproduce normally. The key to
this feat is a gene knockout, affecting the
H19 gene in the oocyte donor, that
appears to short-circuit the requirement for paternal imprinting.
Nature
2004;428:860–64
Nurse practitioners in general practicesExpansion in the workload of general
practitioners has led many countries to shift care to other health
professionals, notably nurses. Nurses can undertake health promotion work and
routine management of chronic diseases such as asthma, diabetes, and coronary
heart disease. A systematic review has shown that nurses can achieve health
outcomes that are as good as those of general practitioners and that they may
have superior interpersonal skills. It is unclear, however, whether nurses
reduce the workload of general practitioners.
In a recent Dutch study involving 34 general practices, the
effects of this nursing intervention has been documented. The number of contacts
during surgery hours increased in the intervention group compared with the
control group (P<0.06), particularly for patients with chronic obstructive
pulmonary disease or asthma (P<0.01). The number of consultations out of
hours declined slightly in the intervention group compared with the control
group, but this difference did not reach significance. Adding nurse
practitioners to general practice teams did not reduce the workload of general
practitioners. This implies that nurse practitioners are used as supplements,
rather than substitutes, for care given by general practitioners.
BMJ
2004;328:927–30.
Medical carousel or czechmate?Hundreds of Czech medical staff have
moved abroad to take up lucrative contracts—and many more are expected to
do so when the country becomes a member of the EU (1/5/04).
There are already 700 Czech physicians, working in Germany,
which in 2002 became the first European country to begin hiring Czech physicians
without requiring them to take additional medical exams.
The migration of medical staff from the east of Europe
westwards is already well documented. Doctors in the economically less well-off
east of Germany have been leaving to work in the relatively more prosperous west
of the country and have been gradually replaced by Czech doctors.
In turn, staff mainly from Slovakia—where
health-sector workers’ wages are lower than the Czech Republic—have
been taken on to fill the gaps in the neighbouring state.
But with Slovakia also becoming a new member of the EU,
Czech doctors fear that their Slovak counterparts will look to western countries
where they can now find work that pays far better than equivalent jobs in the
Czech Republic.
Lancet
2004:363:1443–6
Polio eradication in NigeriaThe northern Nigerian state of Kano
is preparing to reverse its boycott of polio inoculations, which caused a
resurgence of the crippling disease and threatened an international campaign to
eradicate it. Last year Kano boycotted the World Health Organization (WHO)
vaccination campaign because some Muslim clerics had warned that the vaccines
were tainted and would make women sterile. Rumours spread that the vaccines were
a plot by the West to reduce the Muslim population. The WHO welcomed the news as
it opened a week-long conference in Geneva to re-evaluate its chances of
eradicating polio worldwide.
Guardian
Weekly (UK), 28 May–3 June 2004, p29
Hernia repair—laparoscopic technique gives inferior resultsIn a recent large, multicenter,
randomized trial comparing laparoscopic mesh and open mesh repair of inguinal
hernias, men randomly assigned to laparoscopic repair had a higher rate of
recurrence at two years and a higher rate of complications than those assigned
to open repair.
At two years, the relapse rate in the laparoscopic group was
10.1% vs 4.9% in the open repair group (odds ratio 2.2). The authors concluded
that the open technique is superior to the laparoscopic technique fo mesh repair
of primary hernias.
N
Engl J Med 2004;350:1819–27
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Current
issue | Search journal |
Archived issues | Classifieds
| Hotline (free ads) Subscribe | Contribute | Advertise | Contact Us | Copyright | Other Journals |