- Email: [email protected]
Tetanus—a reminder
1210
(16%). Although this difference was not statistically significant, the investigators had predicted that the rate in inpatients would be greater than that in the community cases. These results abused
indicate that childhood sexual abuse does increase the risk of
psychiatric disorders including bulimia nervosa but that the increased risk is not specific to the eating disorder. Sarah Ramsay
chromosome 1 q21-q31. The gene itself remains to be identified, but ANP receptor type A is suggested as a candidate gene. The ANP receptor type A gene is known to map to the same chromosomal region, but ANP receptors have been found in high density on the ciliary body, and animal studies have shown that ANP is increased and ANP binding sites are decreased in the anterior chamber of glaucomatous eyes. Moreover, a single intravenous dose of ANP can reduce intraocular pressure in patients with glaucoma.
Astrid James
Regulating chiropractic The UK is the only English-speaking nation where the regulation of chiropractic is by voluntary arrangements rather than by statute, says a King’s Fund working partyl that has made recommendations on the scope and content of a statutory register to regulate the education, training, and practice of this form of therapy. Chiropractic, the second commonest form of complementary therapy in the UK, is statutorily regulated in 17 other countries. The practice originated in the US and was based on the premise that reduced nerve flow led to disease. In the UK there are about 800 practitioners; the number has doubled in the past 5 years and is expected to double again in the next 5 years. The Anglo-European College of Chiropractic, Bournemouth-the first school to offer training in the UK-was opened in 1965, and in 1988 it became the first complementary medicine college to offer an accredited (4-year) degree course in the UK. Since 1992, graduates have had to undertake an additional year of postgraduate training in clinical practice with a recognised principal to qualify for full registration by the British Chiropractic Association. The Institute for Pure Chiropractic registers graduates of the McTimoney School of Chiropractic in Oxford and The British Association of Applied Chiropractic those from the Witney School of Chiropractic, Oxford. These two schools run part-time diploma courses. The three organisations, which formed the Chiropractic Registration Steering Group in 1991, differ in emphasis on education and training, the use of X-rays, and treatment techniques. In making recommendations the King’s Fund working party used the osteopathy bill that is going through Parliament as a model set of proposals for legislation.
1. Sheffield VC, Stone EM, Alward WLM, et al. Genetic linkage of familial open anyle glaucoma to chromosome 1q21-q31. Nature Genetics 1993; 4:47-50.
Dogs, seizures, and diarrhoea Dogs earn their status as "man’s best friend" by their legendary fidelity-by seeing for the blind, hearing for the deaf, and finding the lost. According to a veterinary surgeon, they can also detect the aura of epilepsy,! Edney identified 37 such dogs who reacted to the aura with barks, with whines, or by "herding" the person to safety; and during the seizure itself kept guard or went for help. The majority of dogs were working dogs (farm or gun dogs), so probably had a closer relationship with their owners than would pets. Because dogs have also been reported to be sensitive to incipient hypoglycaemia in their owners, their usefulness as first-aiders may extend to other acute illnesses. Contact with dogs does, however, carry the risks of catching a number of unpleasant infections including "summer enteritis". Although there are many other reasons why enteric infections should be commonest in the summer, a veterinary epidemiologist suggests that puppies are the source of the summer peak of campylobacter infections.2 The records of the Kennel Club and the Guide Dogs for the Blind Association show that number of births increase during the summer months. Campylobacter is common in puppies (up to a half of those communally reared may be infected). And the route of transmission to man from an unhousetrained puppy may readily be imagined. A mere speculation, maybe, but one that could let crows and magpies3 off the hook.
Vivien Choo 1.
Report of a Working Party on Chiropractic (chairman Rt Hon Sir Thomas Bingham). London: King Edward’s Fund for London. 1993. Pp 51. £5.95. ISBN 1-857170555.
Project held
up in
John
Bignall
1. Edney A, Dogs and human epilepsy. Vet Rec 1933; 132: 337-38. 2. Evans SJ. The seasonality of canine births and human campylobacterosis: a hypothesis. Epidemiol Infect 1993; 110: 267-72. 3. Southern JP, Smith RMM, Palmer SR. Bird attack on milk bottles: a possible mode of transmission of Campylobacter jejuni to man. Lancet 1990; 336: 1425-27.
Mozambique
A large Danish health project has had to be interrupted because the customs department decided to levy a fee before the cars, computers, and equipment sent by the Danish Government would be released. An official from Danida, the Danish Ministry of Foreign Affairs’ office responsible for assistance projects in developing countries, expects the Mozambican authorities to settle the difficulty by themselves. "We are not paying, because we want to spend the money on the project itself’, said Niels Per Sorensen, in charge of the cooperation work with Mozambique. "This is a Mozambican problem for which Danish tax payers can’t pay". Danida runs two health projects in Mozambique, with a total budget of DKr 78 million GC7-8 million). One, with a budget of DKr 52 million, is a continuation of a former UNICEF project aimed at improving maternal and child health care. The other, which has been interrupted, is aimed at improving primary health care in the northeastern Tete province.
Claudio
Csillag
Tetanus—a reminder The UK Communicable Disease Surveillance Centre
(CDR
Weekly 1993; 3: 73) reports that tetanus is still a hazard, especially in the elderly (because they are more likely to be unimmunised). Three recently reported patients, the oldest 76, are described. All recovered, but one required artificial ventilation for two weeks. Tetanus immunisation is safe, cheap, and effective. Should it be offered routinely to the elderly?
China agrees to ban
use
of tiger bones
The Chinese authorities, under pressure from the Indian government, have agreed to ban the use of tiger bones in the preparation of traditional Chinese medicines. They have agreed to sign a protocol with India to effect the ban. The large-scale use of tiger bones in China has depleted the tiger population in India, from where the bones are being illegally exported (see Lancet Jan 2, p 46).
Glaucoma link to ANP?
Director of IARC
Many clinicians are aware that there is an increased incidence of glaucoma among first-degree relatives of affected patients, but few will suspect the gene for atrial natriuretic peptide (ANP) receptor to have a role. However, this is just what is suggested by Sheffield et al in this month’s Nature Geraetics.l In a study of 37 members of a family, all of whom had a 50 % chance of having an early-onset form of open-angle glaucoma, the disease-causing gene was mapped to
Dr P. H. Kleihues has been appointed director of the International Agency for Research on Cancer for a 5-year term starting from Jan 1,1994. From 1976 to 1983 he was director of the division of neuropathy at the University of Freiburg, Germany, and since then he has been a professor at the Institute of Neuropathology in Zurich, Switzerland, and the institute’s director since 1972. He succeeds Dr Lorenzo Tomatis from Italy.
(16%). Although this difference was not statistically significant, the investigators had predicted that the rate in inpatients would be greater than that in the community cases. These results abused
indicate that childhood sexual abuse does increase the risk of
psychiatric disorders including bulimia nervosa but that the increased risk is not specific to the eating disorder. Sarah Ramsay
chromosome 1 q21-q31. The gene itself remains to be identified, but ANP receptor type A is suggested as a candidate gene. The ANP receptor type A gene is known to map to the same chromosomal region, but ANP receptors have been found in high density on the ciliary body, and animal studies have shown that ANP is increased and ANP binding sites are decreased in the anterior chamber of glaucomatous eyes. Moreover, a single intravenous dose of ANP can reduce intraocular pressure in patients with glaucoma.
Astrid James
Regulating chiropractic The UK is the only English-speaking nation where the regulation of chiropractic is by voluntary arrangements rather than by statute, says a King’s Fund working partyl that has made recommendations on the scope and content of a statutory register to regulate the education, training, and practice of this form of therapy. Chiropractic, the second commonest form of complementary therapy in the UK, is statutorily regulated in 17 other countries. The practice originated in the US and was based on the premise that reduced nerve flow led to disease. In the UK there are about 800 practitioners; the number has doubled in the past 5 years and is expected to double again in the next 5 years. The Anglo-European College of Chiropractic, Bournemouth-the first school to offer training in the UK-was opened in 1965, and in 1988 it became the first complementary medicine college to offer an accredited (4-year) degree course in the UK. Since 1992, graduates have had to undertake an additional year of postgraduate training in clinical practice with a recognised principal to qualify for full registration by the British Chiropractic Association. The Institute for Pure Chiropractic registers graduates of the McTimoney School of Chiropractic in Oxford and The British Association of Applied Chiropractic those from the Witney School of Chiropractic, Oxford. These two schools run part-time diploma courses. The three organisations, which formed the Chiropractic Registration Steering Group in 1991, differ in emphasis on education and training, the use of X-rays, and treatment techniques. In making recommendations the King’s Fund working party used the osteopathy bill that is going through Parliament as a model set of proposals for legislation.
1. Sheffield VC, Stone EM, Alward WLM, et al. Genetic linkage of familial open anyle glaucoma to chromosome 1q21-q31. Nature Genetics 1993; 4:47-50.
Dogs, seizures, and diarrhoea Dogs earn their status as "man’s best friend" by their legendary fidelity-by seeing for the blind, hearing for the deaf, and finding the lost. According to a veterinary surgeon, they can also detect the aura of epilepsy,! Edney identified 37 such dogs who reacted to the aura with barks, with whines, or by "herding" the person to safety; and during the seizure itself kept guard or went for help. The majority of dogs were working dogs (farm or gun dogs), so probably had a closer relationship with their owners than would pets. Because dogs have also been reported to be sensitive to incipient hypoglycaemia in their owners, their usefulness as first-aiders may extend to other acute illnesses. Contact with dogs does, however, carry the risks of catching a number of unpleasant infections including "summer enteritis". Although there are many other reasons why enteric infections should be commonest in the summer, a veterinary epidemiologist suggests that puppies are the source of the summer peak of campylobacter infections.2 The records of the Kennel Club and the Guide Dogs for the Blind Association show that number of births increase during the summer months. Campylobacter is common in puppies (up to a half of those communally reared may be infected). And the route of transmission to man from an unhousetrained puppy may readily be imagined. A mere speculation, maybe, but one that could let crows and magpies3 off the hook.
Vivien Choo 1.
Report of a Working Party on Chiropractic (chairman Rt Hon Sir Thomas Bingham). London: King Edward’s Fund for London. 1993. Pp 51. £5.95. ISBN 1-857170555.
Project held
up in
John
Bignall
1. Edney A, Dogs and human epilepsy. Vet Rec 1933; 132: 337-38. 2. Evans SJ. The seasonality of canine births and human campylobacterosis: a hypothesis. Epidemiol Infect 1993; 110: 267-72. 3. Southern JP, Smith RMM, Palmer SR. Bird attack on milk bottles: a possible mode of transmission of Campylobacter jejuni to man. Lancet 1990; 336: 1425-27.
Mozambique
A large Danish health project has had to be interrupted because the customs department decided to levy a fee before the cars, computers, and equipment sent by the Danish Government would be released. An official from Danida, the Danish Ministry of Foreign Affairs’ office responsible for assistance projects in developing countries, expects the Mozambican authorities to settle the difficulty by themselves. "We are not paying, because we want to spend the money on the project itself’, said Niels Per Sorensen, in charge of the cooperation work with Mozambique. "This is a Mozambican problem for which Danish tax payers can’t pay". Danida runs two health projects in Mozambique, with a total budget of DKr 78 million GC7-8 million). One, with a budget of DKr 52 million, is a continuation of a former UNICEF project aimed at improving maternal and child health care. The other, which has been interrupted, is aimed at improving primary health care in the northeastern Tete province.
Claudio
Csillag
Tetanus—a reminder The UK Communicable Disease Surveillance Centre
(CDR
Weekly 1993; 3: 73) reports that tetanus is still a hazard, especially in the elderly (because they are more likely to be unimmunised). Three recently reported patients, the oldest 76, are described. All recovered, but one required artificial ventilation for two weeks. Tetanus immunisation is safe, cheap, and effective. Should it be offered routinely to the elderly?
China agrees to ban
use
of tiger bones
The Chinese authorities, under pressure from the Indian government, have agreed to ban the use of tiger bones in the preparation of traditional Chinese medicines. They have agreed to sign a protocol with India to effect the ban. The large-scale use of tiger bones in China has depleted the tiger population in India, from where the bones are being illegally exported (see Lancet Jan 2, p 46).
Glaucoma link to ANP?
Director of IARC
Many clinicians are aware that there is an increased incidence of glaucoma among first-degree relatives of affected patients, but few will suspect the gene for atrial natriuretic peptide (ANP) receptor to have a role. However, this is just what is suggested by Sheffield et al in this month’s Nature Geraetics.l In a study of 37 members of a family, all of whom had a 50 % chance of having an early-onset form of open-angle glaucoma, the disease-causing gene was mapped to
Dr P. H. Kleihues has been appointed director of the International Agency for Research on Cancer for a 5-year term starting from Jan 1,1994. From 1976 to 1983 he was director of the division of neuropathy at the University of Freiburg, Germany, and since then he has been a professor at the Institute of Neuropathology in Zurich, Switzerland, and the institute’s director since 1972. He succeeds Dr Lorenzo Tomatis from Italy.